Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MA068384 | NJ |
Y | 207QS0010X | Family Doctor - Sports Medicine | 25MA06838400 | NJ |
N | 207QS0010X | Family Doctor - Sports Medicine | MD0441103 | PA |
NPI | 1164553426 |
---|---|
Provider Name | Catharine C Mayer |
First Address | Camden, NJ 08103-1088 |
Second Address | Marlton, NJ 08053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 22/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1028226940001 | (05) | PA |
1391276 | HIGHMARK BLUE SHIELD (01) | PA |
3803211000 | KEYSTONE IBC (01) | PA |
8634469 | AETNA (01) | PA |