Mayer, Gary J.

Mayer, Gary J. is an individual health care provider with primary practice located at 1540 Lake St S , Forest Lake MN 55025-2628. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mayer, Gary J. can be contacted via phone (651) 464-7100.

Contact Information

Primary practice address
1540 Lake St S Forest Lake MN 55025-2628
Phone: (651) 464-7100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24813 Minnesota

Profile Details

NPI number 1235198276
LBN Legal business name Mayer, Gary J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Nov 3rd, 2011 - about 13 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 1235198276 NPPES
Minnesota MEDICAID 171098200

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