Individual
BRIAN ANDREW MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-2000
Mailing address
27789 OSMUN ST, MADISON HEIGHTS, MI 48071-3337
(248) 521-0887
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704276074
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704276074
NURSE ANESTHETIST LICENSE NUMBER
MI
Enumeration date
09/15/2015
Last updated
09/15/2015
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