Provider Demographics
NPI:1568627529
Name:MYERS, TAMARA T (MD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:T
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:104 CHERRY ST APT A
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-1130
Mailing Address - Country:US
Mailing Address - Phone:413-219-7738
Mailing Address - Fax:
Practice Address - Street 1:100 NORTH ACADEMY AVENUE, MC 21-70
Practice Address - Street 2:GEISINGER MEDICAL CENTER, DEPARTMENT OF GENERAL SURGERY
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821
Practice Address - Country:US
Practice Address - Phone:413-219-7738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD205564208600000X
PAMD448861208600000X
CT56500208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery