Individual
BRENT MICHAEL MAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
3884 MONITOR ROAD, BAY CITY, MI 48706-9298
(989) 671-2000
(989) 671-4000
Mailing address
501 LAPEER, SAGINAW, MI 48607-1208
(989) 759-6464
(989) 399-8233
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004410
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080G310660
BLUE CROSS BLUE SHIELD MI
MI
01
—
1012083
MCLAREN HEALTH PLAN
MI
01
—
147434
GREAT LAKES HEALTH PLAN
—
01
—
292
COMMUNITY CHOICE OF MI
—
Enumeration date
11/14/2005
Last updated
04/09/2021
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