Provider Demographics
NPI:1851433411
Name:MAYER, DAVID JOSHUA
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSHUA
Last Name:MAYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 AVIATION AVE
Mailing Address - Street 2:BLDG 1846 USCG HITRON6213
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221
Mailing Address - Country:US
Mailing Address - Phone:904-594-6864
Mailing Address - Fax:
Practice Address - Street 1:6213 AVIATION AVE
Practice Address - Street 2:USCG HITRON6213 BLDG 1846
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-8113
Practice Address - Country:US
Practice Address - Phone:904-594-6864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman