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NPI Code Detail

MEDICARE: MICHELE POLISKIN MYERS MD

MEDICARE: MICHELE POLISKIN MYERS 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
1208000000XPediatrics Physician26736MS
2208000000XPediatrics Physician0101279279VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386039691
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE POLISKIN MYERS MD
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4348 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0720
Country : US
Telephone Number : 540-769-0976
Fax Number : 540-857-5389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2015
Last Update Date : 01/26/2026

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Directions to “ MICHELE POLISKIN MYERS MD” Practice Location

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