Provider Demographics
NPI:1063783546
Name:MAYER, MARTIN GREGORY (PA-C)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:GREGORY
Last Name:MAYER
Suffix:
Gender:M
Credentials:PA-C
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 STANTONSBURG RD
Mailing Address - Street 2:1AD200 HOSPITALIST SUITE
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2818
Mailing Address - Country:US
Mailing Address - Phone:252-847-3898
Mailing Address - Fax:252-847-3891
Practice Address - Street 1:2100 STANTONSBURG RD
Practice Address - Street 2:1AD200 HOSPITALIST SUITE
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2818
Practice Address - Country:US
Practice Address - Phone:252-847-3898
Practice Address - Fax:252-847-3891
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2014-12-23
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Provider Licenses
StateLicense IDTaxonomies
NC0010-03327363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical