Individual
DR. NICHOLAS JOHN MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1265 GRAHAM RD STE 1, FLORISSANT, MO 63031-8018
(314) 741-1600
(314) 741-1677
Mailing address
1265 GRAHAM RD STE 1, FLORISSANT, MO 63031-8018
(314) 741-1600
(314) 741-1677
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
036123985
IL
207RN0300X
Nephrology Physician
Primary
2009007663
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104075597
—
MO
05
—
300117440001
—
IL
Enumeration date
09/10/2008
Last updated
05/22/2024
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