Mayer, Theodore G.

Mayer, Theodore G. is an individual health care provider with primary practice located at Henry Ford Health System 2799 West Grand Boulevard, Detroit MI 48202. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Mayer, Theodore G. can be contacted via phone (313) 916-9106.

Contact Information

Primary practice address
Henry Ford Health System 2799 West Grand Boulevard Detroit MI 48202
Phone: (313) 916-9106
Fax: (313) 916-1249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X 4301089187 Michigan
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 4301089187 Michigan

Profile Details

NPI number 1194732958
LBN Legal business name Mayer, Theodore G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Sep 12th, 2016 - about 9 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 1194732958 NPPES
Other TM089187 CHAMPUS-CHAMPUS
Other TM089187 CHAMPUS-CHAMPUS
MEDICAID 888888810 CHAMPUS-CHAMPUS
Other 700H262270 CHAMPUS-CHAMPUS

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