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1710945415

NPI Code Detail

MEDICARE: MATTHEW THOMAS MAYR M.D.

MEDICARE: MATTHEW THOMAS MAYR M.D.

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	174400000X	Specialist	101236365	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2128643	OTHER	VA	MDIPA,MAMSI,OPTIMUM CHOIC
3	54-1739189	OTHER	VA	FED TAX ID
4	7891521	OTHER	VA	AETNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	2410421	OTHER	VA	UNITED HEALTHCARE
7	3611772	OTHER	VA	US HEALTHCARE-AETNA HMO
8	371483100	OTHER	VA	US DEPT OF LABOR
9	245575	OTHER	VA	SOUTHERN HEALTH
10	3600542	OTHER	VA	CIGNA
11	143843	OTHER	VA	ANTHEM BC/BS
12	90412	OTHER	VA	SENTARA-OPTIMA HEALTH

General Provider Information

NPI Number	:	1710945415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW THOMAS MAYR M.D.

Provider Business Mailing Address
First Line	:	1651 N PARHAM RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4605
Country	:	US
Telephone Number	:	804-288-8248
Fax Number	:	804-282-6223

Provider Business Practice Location Address
First Line	:	1651 N PARHAM RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4605
Country	:	US
Telephone Number	:	804-288-8248
Fax Number	:	804-282-6223

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	01/06/2012

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Directions to “ MATTHEW THOMAS MAYR M.D.” Practice Location

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