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NPI Code Detail

MEDICARE: MATTHEW MYERS

MEDICARE: MATTHEW MYERS
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
1106S00000XBehavior TechnicianRBT-24-333754AZ

General Provider Information

NPI Number : 1619772779
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW MYERS
Provider Business Mailing Address
First Line : 15517 CLEARBROOK ST
Second Line :
City : WESTFIELD
State : IN
Zip : 46074-8095
Country : US
Telephone Number : 317-690-8275
Fax Number :
Provider Business Practice Location Address
First Line : 1143 E 181ST ST
Second Line :
City : WESTFIELD
State : IN
Zip : 46074-8926
Country : US
Telephone Number : 317-480-4002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2025
Last Update Date : 02/13/2025

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Directions to “ MATTHEW MYERS ” Practice Location

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