Provider Demographics
NPI:1811941636
Name:MAEHRER, MARK (DPM)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:MAEHRER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 CETRONIA RD STE 303
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9168
Mailing Address - Country:US
Mailing Address - Phone:610-973-6200
Mailing Address - Fax:866-644-0894
Practice Address - Street 1:250 CETRONIA RD STE 303
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9168
Practice Address - Country:US
Practice Address - Phone:610-973-6200
Practice Address - Fax:866-644-0894
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003852L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA122064OtherMEDPLUS
PA232907386001OtherTHREE RIVERS
PA0776163OtherAETNA
PA0000533000OtherHIGHMARK BLUE SHIELD
PA0015085570002Medicaid
PA1510808OtherGATEWAY
PA480025169OtherRAILROAD MEDICARE
PA0533000OtherKEYSTONE CENTRAL
PA0735292000OtherKEYSTONE EAST
PA01210301OtherCAPITAL BLUE CROSS
PA0735292000OtherAMERIHEALTH
PA0735292000OtherAMERIHEALTH
PA533000Medicare ID - Type Unspecified