Provider Demographics
NPI:1992815708
Name:MAYER, JOHN E JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:MAYER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:FA-144
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-4104
Mailing Address - Fax:617-730-0214
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:FA-144
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-8258
Practice Address - Fax:617-730-0214
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-06-18
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Provider Licenses
StateLicense IDTaxonomies
MA52467208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6176763Medicaid
MAB97726Medicare UPIN
J0334901Medicare PIN
J03349Medicare PIN