Provider Demographics
NPI:1730292871
Name:MAYER, ANNE MARGARET (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARGARET
Last Name:MAYER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2236 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5770
Mailing Address - Country:US
Mailing Address - Phone:717-761-2295
Mailing Address - Fax:717-761-8123
Practice Address - Street 1:4900 CARLISLE PIKE
Practice Address - Street 2:HAMPDEN OPTICAL
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-661-2295
Practice Address - Fax:717-761-8123
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEOO-7049P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396572OtherCAPITAL BLUE CROSS ID#
PA396572OtherNVA PROVIDER ID#
PAMA565249OtherBLUE SHIELD ID#
PAMA565249OtherBLUE SHIELD ID#
PA396572OtherNVA PROVIDER ID#