Provider Demographics
NPI:1942254693
Name:MAYER, PAUL G (CRNA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:G
Last Name:MAYER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5276 OLD SHELL ROAD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608
Mailing Address - Country:US
Mailing Address - Phone:251-342-1877
Mailing Address - Fax:205-322-1305
Practice Address - Street 1:3610 SPRINGHILL MEMORIAL DR N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1162
Practice Address - Country:US
Practice Address - Phone:251-342-3000
Practice Address - Fax:251-342-3043
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-046191367500000X
GARN183952367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA345495255BMedicaid
AL051557014Medicare ID - Type Unspecified
GA345495255BMedicaid