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Individual
DR. PHILIP A. MAYNARD
Active
Individual
DR. PHILIP A. MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
00365
IA
213E00000X
Podiatrist
159
NE
213ES0131X
Foot Surgery Podiatrist
00365
IA
213ES0131X
Foot Surgery Podiatrist
Primary
159
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02513
BC-BS OF NE
NE
01
—
1197710001
DME NORIDAN
NE
05
—
47062581300
—
NE
01
—
480021803
RAILROAD MEDICARE
NE
Enumeration date
05/24/2005
Last updated
01/02/2013
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