Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 11013692A | IN |
Y | 207SG0201X | Clinical Genetics (M.D.) | 8680 | SD |
N | 207SG0201X | Clinical Genetics (M.D.) | A113993 | CA |
NPI | 1336302777 |
---|---|
Provider Name | Dr. Angela Myers |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57105-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 01/05/2014 |