Mary Hafer, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

M-7753 Issued in ID

Legal business name

MARY HAFER, MD

Practice address

2971 E Copper Point Dr
Suite # 125
Meridian, ID 83642-5101

Phone

(208) 893-5383

Fax

(208) 893-5386

NPI assigned

Apr 4, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michele Janee Loucao

Title

Office Manager

Phone

(208) 893-5383

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Poly, PA

  • Medical Physician Assistant
  • Boise, ID
  • NPI 1386933513
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1154610731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 E COPPER POINT DR",
            "address_2": "SUITE # 125",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425101",
            "telephone_number": "208-893-5383",
            "fax_number": "208-893-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 E COPPER POINT DR",
            "address_2": "SUITE # 125",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425101",
            "telephone_number": "208-893-5383",
            "fax_number": "208-893-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY HAFER, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "LOUCAO",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "JANEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-893-5383"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "ID",
            "license": "M-7753",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-895",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO STATE MEDICAL LICENSE",
            "identifier": "M-7753",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Martinson
• Anna Martsenyuk, APRN, ACNS-BC
• Denise Marx
• Hannah Camille Marx
• Mary Field Counseling
• Abbie Mata
• Cedric Matamba
• Anna V Matlashevsky, PHARM. D
• Matters Counseling and Consulting
• Cassidy Leath Matthews

• Specialist in Meridian, ID
• Providers in Meridian, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.