Mary Hafer, Md
LBN: Mary Hafer, Md
Mary Hafer, Md is an health care organization with primary practice located at 2971 E Copper Point Dr Suite # 125, Meridian ID 83642-5101. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Physician Assistants & Advanced Practice Nursing Providers / Medical. Other Service Providers / Specialist is the primary health care specialty.
Mary Hafer, Md can be contacted via phone (208) 893-5383, or through Loucao, Michele Janee via phone (208) 893-5383.
Contact Information
Primary practice address
2971 E Copper Point Dr Suite # 125
Meridian ID 83642-5101
Phone: (208) 893-5383
Fax: (208) 893-5386
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | M-7753 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA-895 | Idaho |
Profile Details
| NPI number | 1154610731 |
|---|---|
| LBN Legal business name | Mary Hafer, Md |
| DBA Doing business as | |
| Authorized official | Loucao, Michele Janee |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 4th, 2011 |
| Last updated | Apr 4th, 2011 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154610731 | NPPES |
| Idaho | Other | M-7753 | IDAHO STATE MEDICAL LICENSE |
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