Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 166815 | NY |
Y | 208800000X | Urologist | MD12010 | OR |
N | 208800000X | Urologist | MD60890461 | WA |
NPI | 1073552352 |
---|---|
Provider Name | Robert D Mayer |
First Address | Medford, OR 97504-8383 |
Second Address | Grants Pass, OR 97527-5788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1487696985 | CURRY GENERAL HOSPITAL NPI (01) | OR |
500666607 | (05) | OR |