Individual
DR. MAIA S MCCUISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
106 IRVING ST NW STE 2300, WASHINGTON, DC 20010-2959
(202) 291-6257
Mailing address
106 IRVING ST NW STE 218, WASHINGTON, DC 20010-2993
(734) 972-4571
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101236606
VA
208000000X
Pediatrics Physician
D72871
MD
208000000X
Pediatrics Physician
Primary
MD039436
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010090261
—
VA
01
—
146389
ANTHEM
VA
01
—
248036
SOUTHERN HEALTH
VA
01
—
54088505619
JOHN DEERE
VA
01
—
7390570
AETNA
VA
01
—
7666441
CIGNA
VA
01
—
8127352
MAMSI
VA
Enumeration date
06/09/2005
Last updated
05/13/2021
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