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MAYA FIELDS INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1299 INTERSTATE PKWY, AUGUSTA, GA 30909-6481
(706) 863-2246
Mailing address
2467 GOLDEN CAMP RD, AUGUSTA, GA 30906-5515
(706) 790-4440
(706) 790-4393

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
34745
SC
208000000X
Pediatrics Physician
5512
GA
208000000X
Pediatrics Physician
Primary
87472
GA

Other

Enumeration date
06/26/2012
Last updated
02/19/2021
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