Individual
DR. MAISIE IRENE MARTINICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 E. BROAD STREET WEST HOSPITAL - W6S, GME ADMINISTRATION POB 980257, RICHMOND, VA 23298-0257
(804) 828-9783
(804) 828-5613
Mailing address
5300 MILITARY ROAD, MOUNT ST. MARY'S HOSPITAL, LEWISTON, NY 14092
(716) 297-4800
(804) 828-8682
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101257763
VA
207L00000X
Anesthesiology Physician
Primary
272924
NY
207L00000X
Anesthesiology Physician
9544203
NY
Other
Enumeration date
03/30/2010
Last updated
03/18/2020
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