Provider Demographics
NPI:1114009214
Name:MAYER, MARION JOYCE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:JOYCE
Last Name:MAYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GLENKIRK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6921
Mailing Address - Country:US
Mailing Address - Phone:843-852-7844
Mailing Address - Fax:
Practice Address - Street 1:1 GLENKIRK DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-6921
Practice Address - Country:US
Practice Address - Phone:843-852-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine