MEDICARE: DR. ADAM JOEL MYERS D.D.S.

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	1223G0001X	General Practice Dentistry	3901	WV

General Provider Information

NPI Number	:	1144549411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM JOEL MYERS D.D.S.

Provider Business Mailing Address
First Line	:	1189 PINEVIEW DR
Second Line	:	SUITE A
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-2780
Country	:	US
Telephone Number	:	304-598-2030
Fax Number	:	304-598-0230

Provider Business Practice Location Address
First Line	:	1189 PINEVIEW DR
Second Line	:	SUITE A
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-2780
Country	:	US
Telephone Number	:	304-598-2030
Fax Number	:	304-598-0230

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

Provider Enumeration Date	:	05/25/2010
Last Update Date	:	05/25/2010

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