Provider Demographics
NPI:1497795728
Name:MEHR, DAVID S (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:MEHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-0276
Mailing Address - Country:US
Mailing Address - Phone:801-263-0810
Mailing Address - Fax:801-270-8170
Practice Address - Street 1:750 W 800 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3660
Practice Address - Country:US
Practice Address - Phone:801-263-0810
Practice Address - Fax:801-270-8170
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT276277-1205207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT220026020OtherPALMETTO GBA RAILRROAD ME
UT27627712001001OtherBLUE CROSS BLUE SHIELD
UT870629575004Medicaid
UT11-90083OtherUNITED HEALTH CARE
UTQM0000076386OtherALTIUS
UTD20475Medicare UPIN
UT220026020OtherPALMETTO GBA RAILRROAD ME