MEDICARE: TODD RICHARD MYERS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	19171	WV
2	207V00000X	Obstetrics & Gynecology Physician	35075798M	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01331374	OTHER	OH	RAILROAD MEDICARE - MHCPI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023011673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD RICHARD MYERS M.D.

Provider Business Mailing Address
First Line	:	406 4TH ST
Second Line	:
City	:	MARIETTA
State	:	OH
Zip	:	45750-2003
Country	:	US
Telephone Number	:	740-516-8133
Fax Number	:	740-568-0057

Provider Business Practice Location Address
First Line	:	1113 WASHINGTON ST
Second Line	:
City	:	RAVENSWOOD
State	:	WV
Zip	:	26164-1020
Country	:	US
Telephone Number	:	740-516-8133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	10/16/2024

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