Individual
NICOLAS MAXYMIV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1250 E. MARSHALL ST., BOX 980459, RICHMOND, VA 23298
(804) 828-0733
(804) 828-8682
Mailing address
1250 E. MARSHALL ST., BOX 980459, RICHMOND, VA 23298
(540) 819-4134
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0102204260
VA
207LP2900X
Pain Medicine (Anesthesiology) Physician
0102204260
VA
Other
Enumeration date
04/25/2014
Last updated
03/09/2020
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