MEDICARE: MRS. ASHLEY MARIE MEYERS 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	363A00000X	Physician Assistant	5601005979	MI

General Provider Information

NPI Number	:	1699059907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY MARIE MEYERS PA-C

Provider Business Mailing Address
First Line	:	706 W HURON ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-4212
Country	:	US
Telephone Number	:	734-996-8757
Fax Number	:	734-996-8767

Provider Business Practice Location Address
First Line	:	706 W HURON ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-4212
Country	:	US
Telephone Number	:	734-996-8757
Fax Number	:	734-996-8767

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

Provider Enumeration Date	:	10/05/2011
Last Update Date	:	11/26/2013

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