MEDICARE: DR. BRIAN GERALD MYERS M.D.

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	9900107	NC

General Provider Information

NPI Number	:	1710062799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN GERALD MYERS M.D.

Provider Business Mailing Address
First Line	:	40520 COUNTY HIGHWAY 34
Second Line	:
City	:	OGEMA
State	:	MN
Zip	:	56569-9612
Country	:	US
Telephone Number	:	218-983-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 MOUNT HOLLY HUNTERSVILLE RD
Second Line	:	SUITE 200
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-8644
Country	:	US
Telephone Number	:	704-399-7800
Fax Number	:

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	10/19/2017

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