Individual
SAMUEL BENEDICT MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1 SHAWS CV, NEW LONDON, CT 06320-4902
(860) 447-8304
Mailing address
749 9TH ST UNIT 203, DURHAM, NC 27705-1060
(504) 432-5708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
162343
CT
363LF0000X
Family Nurse Practitioner
Primary
8305
CT
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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