Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 10450 | NV |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME110071 | FL |
NPI | 1043283898 |
---|---|
Provider Name | Marcus C Mayer |
First Address | Boca Raton, FL 33486 |
Second Address | Boynton Beach, FL 33426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 04/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002002303 | (05) | NV |
E48878 | (02) |