David, Douglas Mayer

David, Douglas Mayer is an individual health care provider with primary practice located at 1815 E Ireland Rd , South Bend IN 46614-2845. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. David, Douglas Mayer can be contacted via phone (574) 647-1700.

Contact Information

Primary practice address
1815 E Ireland Rd South Bend IN 46614-2845
Phone: (574) 647-1700
Fax: (574) 647-7572
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01043622A Indiana

Profile Details

NPI number 1396733101
LBN Legal business name David, Douglas Mayer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Apr 1st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396733101 NPPES
Indiana Other 169380E MEDICARE PTAN
Indiana MEDICAID 200047740 MEDICARE PTAN

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