Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD00046087 | WA |
N | 2080P0210X | Pediatric Nephrologist | MD00046087 | WA |
NPI | 1407863467 |
---|---|
Provider Name | Dr. David Arthur Myers |
First Address | Shelton, WA 98584-4404 |
Second Address | Shelton, WA 98584-4404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 29/01/2019 |