Individual
DONALD MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1612B MILSTEAD RD NE, CONYERS, GA 30012-3738
(770) 602-1292
(770) 602-1296
Mailing address
1612B MILSTEAD RD NE, CONYERS, GA 30012-3738
(770) 602-1292
(770) 602-1296
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
052463
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1668867111A
—
GA
Enumeration date
05/28/2006
Last updated
05/07/2024
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