1609978154 NPI number — DR. ANGELA MARIA MAIER MD

Table of content: DR. ANGELA MARIA MAIER MD (NPI 1609978154)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609978154 NPI number — DR. ANGELA MARIA MAIER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAIER
Provider First Name:
ANGELA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609978154
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5410 MARYLAND WAY
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-5339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-377-5602
Provider Business Mailing Address Fax Number:
615-270-1692

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
809 CURRY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27205-6715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-628-4200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  201702546 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 005470800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".