MEDICARE: MR. EDWARD JULIAN MEYERS MD

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	207P00000X	Emergency Medicine Physician	28747	SC
2	207P00000X	Emergency Medicine Physician	79801	OH
3	208D00000X	General Practice Physician	28747	SC
4	207P00000X	Emergency Medicine Physician	0101236147	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	I263838286	OTHER	SC	MEDICARE PROVIDER ID #

General Provider Information

NPI Number	:	1083631618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD JULIAN MEYERS MD

Provider Business Mailing Address
First Line	:	325 BROAD ST STE 100
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-4167
Country	:	US
Telephone Number	:	803-773-5227
Fax Number	:	803-753-9312

Provider Business Practice Location Address
First Line	:	325 BROAD ST STE 100
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-4167
Country	:	US
Telephone Number	:	803-773-5227
Fax Number	:	803-753-9312

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	03/18/2026

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