Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01075111A | IN |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 01075111A | IN |
NPI | 1184858763 |
---|---|
Provider Name | Dr. David Kenneth Myer |
First Address | Indianapolis, IN 46278-1381 |
Second Address | Indianapolis, IN 46278-1381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2009 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201173280 | (05) | IN |