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General NPI Number Information
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NPI Number | 1972445120
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Entity Type | Individual
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Provider Name | GARY MITCHELL MYERS JR. RN
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Gender | Male
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 310 WINDWARD DR SW
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City | ROANOKE
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State | VA
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Zip | 24018-0715
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Country | US
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Telephone | 540-982-2463
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Fax | 540-224-1944
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Provider Business Mailing Address
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Address Line | 310 WINDWARD DR SW
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City | ROANOKE
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State | VA
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Zip | 24018-0715
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001174465
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License Number State | VA
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