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General NPI Number Information
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NPI Number | 1972241693
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Entity Type | Individual
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Provider Name | CAROLINE SNOWDEN MYERS MD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 3400 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-1700
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Country | US
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Telephone | 215-662-2737
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Fax |
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Provider Business Mailing Address
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Address Line | 180 HARVESTER DR STE 110
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City | BURR RIDGE
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State | IL
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Zip | 60527-6686
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Country | US
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Telephone | 773-702-1150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MT229834
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License Number State | PA
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