Healthcare Provider Details

I. General information

NPI: 1306200225
Provider Name (Legal Business Name): WILLIAM FREDERICK MAYERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CUMMINGS CTR STE 221U
BEVERLY MA
01915-6183
US

IV. Provider business mailing address

900 CUMMINGS CTR STE 221U
BEVERLY MA
01915-6183
US

V. Phone/Fax

Practice location:
  • Phone: 978-927-7246
  • Fax: 978-927-7249
Mailing address:
  • Phone: 978-927-7246
  • Fax: 978-927-7249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036148264
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number287639
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: