Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101-237955 | VA |
Y | 207X00000X | Orthopaedic Surgeon | MD205645 | OR |
N | 207XS0106X | Orthopaedic Hand Surgeon | 0101237955 | VA |
NPI | 1083688931 |
---|---|
Provider Name | Cay Michael Mierisch |
First Address | Corvallis, OR 97339-1189 |
Second Address | Corvallis, OR 97330-3785 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 13/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083688931 | (05) | VA |
1083688931 | AETNA (01) | VA |
1083688931 | ANTHEM (01) | VA |
1083688931 | CIGNA (01) | VA |
1083688931 | GATEWAY (01) | VA |
1083688931 | HEALTHKEEPERS (01) | VA |
1083688931 | HEALTHKEEPERS PLUS (01) | VA |
1083688931 | HUMANA MEDICARE (01) | VA |
1083688931 | INTOTAL (01) | VA |
1083688931 | MEDICAID OF NORTH CAROLINA (01) | VA |
1083688931 | OPTIMA HEALTH PLAN (01) | VA |
1083688931 | SOUTHERN HEALTH/CARENET/CARELINK/COVENTRY (01) | VA |
1083688931 | UMWA (01) | VA |
1083688931 | UNITED HEALTHCARE (01) | VA |
1083688931 | VA PREMIER (01) | VA |
1083688931 | VIRGINIA HEALTH NETWORK (01) | VA |
371194700 | BLACK LUNG (01) | VA |
3810010052 | MEDICAID OF WEST VIRGINIA (01) | VA |
540506332004 | TRICARE/CHAMPUS (01) | VA |
I13624 | (02) | VA |
P00239901 | RAILROAD MEDICARE (01) | VA |