Provider Demographics
NPI:1306809678
Name:MYERS, DONALD J (PA-C)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:MYERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 NEW RD
Mailing Address - Street 2:CENTRAL PARK EAST
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1299
Mailing Address - Country:US
Mailing Address - Phone:609-927-9790
Mailing Address - Fax:609-926-8796
Practice Address - Street 1:222 NEW RD
Practice Address - Street 2:CENTRAL PARK EAST
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1299
Practice Address - Country:US
Practice Address - Phone:609-927-9790
Practice Address - Fax:609-926-8796
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00147600363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical