MEDICARE: DR. TINA M MYERS DO

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	OS010832L	PA

General Provider Information

NPI Number	:	1437127230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA M MYERS DO

Provider Business Mailing Address
First Line	:	801 OSTRUM ST
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18015-1000
Country	:	US
Telephone Number	:	484-526-6048
Fax Number	:	484-526-6500

Provider Business Practice Location Address
First Line	:	2793 GERYVILLE PIKE
Second Line	:
City	:	PENNSBURG
State	:	PA
Zip	:	18073-2306
Country	:	US
Telephone Number	:	267-424-8200
Fax Number	:	215-541-2987

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	04/03/2012

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