MEDICARE: KAREN ELIZABETH MYERS PA-C

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	363AM0700X	Medical Physician Assistant	MA054444	PA
2	363A00000X	Physician Assistant	0010-06236	NC

General Provider Information

NPI Number	:	1528371341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ELIZABETH MYERS PA-C

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:	STE 135, P O BOX 37
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-384-1725
Fax Number	:	704-384-1726

Provider Business Practice Location Address
First Line	:	5325 VINNING ST NW STE 101
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-2956
Country	:	US
Telephone Number	:	704-316-1040
Fax Number	:

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

Provider Enumeration Date	:	07/21/2010
Last Update Date	:	04/17/2023

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