Individual
BEN R MAYNE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 W WACKERLY ST, SUITE 2600, MIDLAND, MI 48640
(989) 839-8865
(989) 631-7337
Mailing address
555 W WACKERLY ST, SUITE 2600, MIDLAND, MI 48640-4722
(989) 839-8865
(989) 631-7337
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301406830
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2738032
—
MI
Enumeration date
07/07/2006
Last updated
09/04/2018
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