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NPI Code Detail

MEDICARE: DR. CHARLES JACOB MAYER MD

MEDICARE: DR. CHARLES JACOB MAYER MD
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
1207Q00000XFamily Medicine PhysicianDR.0067844CO
2207Q00000XFamily Medicine PhysicianMD00031331WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22000015OTHERINTERNAL ID-MOTOR VEHICLE ID

General Provider Information

NPI Number : 1487739298
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES JACOB MAYER MD
Provider Business Mailing Address
First Line : 1420 5TH AVE STE 375
Second Line :
City : SEATTLE
State : WA
Zip : 98101-4032
Country : US
Telephone Number : 206-223-2611
Fax Number :
Provider Business Practice Location Address
First Line : 1420 5TH AVE STE 375
Second Line :
City : SEATTLE
State : WA
Zip : 98101-4032
Country : US
Telephone Number : 206-223-2611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 04/14/2022

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Directions to “ DR. CHARLES JACOB MAYER MD” Practice Location

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