Provider Demographics
NPI:1043290240
Name:MYERS, HERBERT (DO)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1630 13TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3812
Practice Address - Country:US
Practice Address - Phone:304-697-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1195207V00000X
OH34003973M207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000178445OtherANTHEM BC
OH001709561OtherMT. STATE
WV0091585000Medicaid
WV001709560OtherMT. STATE
OH0746750Medicaid
WVWV1913Medicaid
KY64697477Medicaid
WVWV1913C196Medicare PIN
WV001709560OtherMT. STATE
WV0659948Medicare PIN
WV2015073Medicare PIN
OH000000178445OtherANTHEM BC
WVWV1913Medicaid
WV2015075Medicare PIN
WVWV1913C197Medicare PIN
WVE54325Medicare UPIN
WV2015074Medicare PIN
WVWV1913CMedicare PIN
WVWV1913C447Medicare PIN
OH001709561OtherMT. STATE
WVWV1913EMedicare PIN
WVWV1913C455Medicare PIN
WVWV1913DMedicare PIN
WV2015071Medicare PIN