Provider Demographics
NPI:1003946062
Name:MAYER, DAVID R (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:MAYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2903 WALL TRIANA HWY STE 6
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35824-1537
Mailing Address - Country:US
Mailing Address - Phone:256-464-9085
Mailing Address - Fax:256-464-0193
Practice Address - Street 1:2903 WALL TRIANA HWY STE 6
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35824-1537
Practice Address - Country:US
Practice Address - Phone:256-464-9085
Practice Address - Fax:256-464-0193
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051019362OtherBCBS PROVIDER #