Individual
MATTHEW MAIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 ACCESS RD # 4, PASCAGOULA, MS 39567-4485
(228) 935-3252
Mailing address
14801 LEMOYNE BLVD APT 359, BILOXI, MS 39532-7035
(228) 935-3252
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
010128359
VA
Other
Enumeration date
04/28/2023
Last updated
08/22/2024
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