Basic Information
| Provider Information | |||||||||
| NPI: | 1356312037 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MYERS | ||||||||
| FirstName: | COLLIN | ||||||||
| MiddleName: | LEWIS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7177096529 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172682332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172176800 | ||||||||
| FaxNumber: | 7172176900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 04/13/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD045853L | PA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 8998452 | 01 | PA | AETNA HMO | OTHER | 001549470 | 05 | PA | MEDICAID | 102234941 | 05 | PA | MEDICAID | 804550 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 5531100 | 01 | PA | AETNA NON HMO | OTHER | 945951 | 01 | MD | CAREFIRST MD BCBS | OTHER | 227275 | 01 | PA | JOHNS HOPKINS | OTHER | 50083030 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 259370 | 01 | PA | UNISON-WMG | OTHER |