Provider Demographics
NPI:1902996176
Name:MEYERS, FREDERIC ALAN (MD)
Entity Type:Individual
Prefix:
First Name:FREDERIC
Middle Name:ALAN
Last Name:MEYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 REECEVILLE RD STE C
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1572
Mailing Address - Country:US
Mailing Address - Phone:610-384-6076
Mailing Address - Fax:610-384-4825
Practice Address - Street 1:217 REECEVILLE RD STE C
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1572
Practice Address - Country:US
Practice Address - Phone:610-384-6076
Practice Address - Fax:610-384-4825
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031687E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA408003ES4OtherMEDICARE
PA0010283470006Medicaid
C33558Medicare UPIN