Organization
LSMAYNARD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STUART MAYNARD (PH.D. CNS)
(301) 656-6605
Entity
Organization
Contact information
Practice address
4500 N PARK AVE STE N801, CHEVY CHASE, MD 20815-7239
(301) 656-6605
Mailing address
4500 N PARK AVE STE N801, CHEVY CHASE, MD 20815-7239
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R066358
MBON
MD
Enumeration date
12/20/2019
Last updated
12/20/2019
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