# DR. MARY AGNES MAYTAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1821026485
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 200028 | LA | — |
| 207Q00000X | Family Medicine Physician | 44037 | MN | — |
| 207Q00000X | Family Medicine Physician | DR.0064049 | CO | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 10/06/2021