Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | D0023286 | MD |
NPI | 1235482225 |
---|---|
Provider Name | Dr. Roy A.m Myers |
First Address | Minneapolis, MN 55416-4269 |
Second Address | Minneapolis, MN 55416-4269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 09/05/2017 |