Provider Demographics
NPI:1861465486
Name:MAYER, DAVID N (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:MAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-582-2105
Mailing Address - Fax:413-586-8443
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-586-8443
Practice Address - Fax:413-586-8443
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253202207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA253202OtherCONNECTICARE
MA122775OtherBMC HEALTHNET
CO07037741Medicaid
MA402861OtherTUFTS HEALTH PLAN
MAJ50823OtherBCBS OF MASS
MA7258580OtherAETNA
MA253202OtherCONNECTICARE
CO07037741Medicaid
G65949Medicare UPIN