Provider Demographics
NPI:1255410825
Name:KATZ, MAYER M (MD)
Entity type:Individual
Prefix:DR
First Name:MAYER
Middle Name:M
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:33664 BAYVIEW MEDICAL DR
Mailing Address - Street 2:UNIT 2
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1687
Mailing Address - Country:US
Mailing Address - Phone:302-644-4954
Mailing Address - Fax:302-645-5481
Practice Address - Street 1:33664 BAYVIEW MEDICAL DR
Practice Address - Street 2:UNIT 2
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1687
Practice Address - Country:US
Practice Address - Phone:302-644-4954
Practice Address - Fax:302-645-5481
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-00034862086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000235901Medicaid
DE000B50D36Medicare ID - Type Unspecified
DE0000235901Medicaid