Healthcare Provider Details
I. General information
NPI: 1255372561
Provider Name (Legal Business Name): DAVID C. MAYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6701 AIRPORT BLVD SUITE D-330
MOBILE AL
36608-6705
US
IV. Provider business mailing address
6701 AIRPORT BLVD SUITE D-330
MOBILE AL
36608-6705
US
V. Phone/Fax
- Phone: 251-607-9797
- Fax: 251-607-9761
- Phone: 251-607-9797
- Fax: 251-607-9761
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 00010407 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: