Provider Demographics
NPI:1588725634
Name:MYERS, CHARLES J (DC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:MYERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 HILLTOP RD
Mailing Address - Street 2:APT K
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5254
Mailing Address - Country:US
Mailing Address - Phone:336-854-3545
Mailing Address - Fax:
Practice Address - Street 1:5030 HILLTOP RD
Practice Address - Street 2:APT K
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-5254
Practice Address - Country:US
Practice Address - Phone:336-854-3545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1283111N00000X
PADC001938L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085AFOtherBCBS
2454124Medicare ID - Type Unspecified
NC085AFOtherBCBS