Individual
ANDREW MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 E PORTLAND ST UNIT 153, PHOENIX, AZ 85004-1973
(520) 440-7269
Mailing address
113 BRIXWORTH LANE, APT #2, NASHVILLE, TN 37205
(520) 440-7269
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/15/2015
Last updated
12/27/2015
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