Provider Demographics
NPI:1619849445
Name:MAYER, MICHAEL CASPER
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CASPER
Last Name:MAYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 19TH ST NW STE 316
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3633
Mailing Address - Country:US
Mailing Address - Phone:301-652-8847
Mailing Address - Fax:202-331-1656
Practice Address - Street 1:1120 19TH ST NW STE 316
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3633
Practice Address - Country:US
Practice Address - Phone:301-652-8847
Practice Address - Fax:202-331-1656
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01733231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist