Individual
JENNIFER M MAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 STURDY RD, VALPARAISO, IN 46383-4126
(219) 462-7173
(219) 462-7504
Mailing address
2401 VALLEY DR, VALPARAISO, IN 46383-2520
(219) 477-6082
(219) 465-9502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11013641A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200997830
—
IN
Enumeration date
06/13/2007
Last updated
01/21/2019
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