MEDICARE: DR. DAVID R MAYER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DO-139	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051019362	OTHER	AL	BCBS PROVIDER #

General Provider Information

NPI Number	:	1003946062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID R MAYER D.O.

Provider Business Mailing Address
First Line	:	2903 WALL TRIANA HWY STE 6
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35824-1537
Country	:	US
Telephone Number	:	256-464-9085
Fax Number	:	256-464-0193

Provider Business Practice Location Address
First Line	:	2903 WALL TRIANA HWY STE 6
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35824-1537
Country	:	US
Telephone Number	:	256-464-9085
Fax Number	:	256-464-0193

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	05/21/2019

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Directions to “ DR. DAVID R MAYER D.O.” Practice Location

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