Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | J0598 | TX |
N | 207XS0117X | Orthopaedic Spine Surgeon | 29129 | NE |
Y | 207XS0117X | Orthopaedic Spine Surgeon | J0598 | TX |
NPI | 1063477289 |
---|---|
Provider Name | Dr. Henrik Mike-Mayer |
First Address | Rowlett, TX 75088-6713 |
Second Address | Rowlett, TX 75088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 31/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F07833 | (02) |