Provider Demographics
NPI:1487837936
Name:DANIEL S. MEHR, M.D., P.C.
Entity Type:Organization
Organization Name:DANIEL S. MEHR, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-423-7953
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-0518
Mailing Address - Country:US
Mailing Address - Phone:801-423-7953
Mailing Address - Fax:
Practice Address - Street 1:25 E LOAFER RD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:UT
Practice Address - Zip Code:84653-2090
Practice Address - Country:US
Practice Address - Phone:801-423-7953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G40008Medicare UPIN