Basic Information
| Provider Information | |||||||||
| NPI: | 1518932672 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MYERS | ||||||||
| FirstName: | PHILIP | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P O BOX 829641 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673705296 | ||||||||
| FaxNumber: | 2152303725 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 FARM LANE | ||||||||
| Address2: | |||||||||
| City: | DOYLESTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189014732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153483990 | ||||||||
| FaxNumber: | 2153487705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2006 | ||||||||
| LastUpdateDate: | 03/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD032809E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2119896001 | 01 | KEYSTONE HEALTH PLAN EAST | OTHER | 4708888939 | 01 | FIRST HEALTH CCN | OTHER | P543145 | 01 | OXFORD | OTHER | 10367500002 | 01 | PA MEDICAL ASSISTANCE | OTHER | 007302 | 01 | AETNA PPO MANAGED CARE | OTHER | 1058233 | 01 | KEYSTONE MERCY HEALTHPLAN | OTHER | 2119896001 | 01 | PERSONAL CHOICE 65 | OTHER | 0010367500 | 05 | PA | MEDICAID | 280685 | 01 | MAMSI | OTHER | 059248 | 01 | PA | BLUE SHIELD | OTHER | 110243166 | 01 | MEDICARE RAILROAD | OTHER | 470888939 | 01 | HEALTH NET | OTHER | 2119896001 | 01 | AMERIHEALTH ADMINISTRATOR | OTHER | 2119896001 | 01 | KEYSTONE LIAISON | OTHER | 470888939 | 01 | MULTI PLAN | OTHER | 0010367500002 | 05 | PA | MEDICAID | 007302 | 01 | AETNA HMO | OTHER | 4708888939 | 01 | DEVON | OTHER | 470888939 | 01 | INTERCOUNTY | OTHER |