Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301088333 | MI |
NPI | 1013124015 |
---|---|
Provider Name | Mark D Mayer |
First Address | Coldwater, MI 49036-2068 |
Second Address | Coldwater, MI 49036-2068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 13/01/2014 |