Individual
DIANE M MAYLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD STE 220, GREEN BAY, WI 54311-6519
(920) 288-8230
(920) 288-8235
Mailing address
2845 GREENBRIER RD STE 220, PO BOX 8900, GREEN BAY, WI 54308-8900
(920) 288-8230
(920) 288-8235
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
28780
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040017579
RAILROAD
WI
05
—
104541671
—
MI
05
—
31777000
—
WI
Enumeration date
06/20/2006
Last updated
09/03/2008
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