Organization
ANNETTE F MAYES MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE F MAYES MD (PHYSICIAN, OWNER)
(702) 522-9640
Entity
Organization
Contact information
Practice address
700 SHADOW LN, SUITE 165, LAS VEGAS, NV 89106-4126
(702) 522-9640
Mailing address
700 SHADOW LANE, SUITE 165, LAS VEGAS, NV 89106
(702) 522-9640
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
7200
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019271
—
NV
01
—
V35155
MEDICARE PTAN
NV
Enumeration date
05/22/2015
Last updated
05/22/2015
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