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MUAD MAYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1035 WALL ST STE 103, JEFFERSONVILLE, IN 47130-3695
(812) 283-9111
(812) 283-9001
Mailing address
2200 POLO MOUNT CT, LOUISVILLE, KY 40245-5431

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35833
KY
207RN0300X
Nephrology Physician
Primary
01051552A
IN
207RN0300X
Nephrology Physician
35833
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200417620
IN
05
64059876
KY
01
P01669938
RAILROAD MEDICARE
IN
Enumeration date
03/31/2006
Last updated
08/25/2016
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