Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 23796 | WV |
N | 208000000X | Pediatrician | 27151 | KY |
N | 2080P0216X | Pediatric Rheumatologist | 27151 | KY |
NPI | 1750307187 |
---|---|
Provider Name | Richard John Mier |
First Address | Martinsburg, WV 25402 |
Second Address | Martinsburg, WV 25401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 13/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64217516 | (05) | KY |
C65780 | (02) |