Provider Demographics
NPI:1316943020
Name:MYERS, DAVID B (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 CAMDEN DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2813
Mailing Address - Country:US
Mailing Address - Phone:406-656-8385
Mailing Address - Fax:406-238-6068
Practice Address - Street 1:1903 CAMDEN DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2813
Practice Address - Country:US
Practice Address - Phone:406-656-8385
Practice Address - Fax:406-238-6068
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3460208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0067418Medicaid
MT94830Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
MTD20600Medicare UPIN