Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 35.099797 | OH |
Y | 207YP0228X | Pediatric Otolaryngology | 35.099797 | OH |
NPI | 1760693063 |
---|---|
Provider Name | Charles Myer IV |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 12/04/2018 |