Individual
DR. WALISA K MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
4040 HOSPITAL WEST DR, AUSTELL, GA 30106-8117
(770) 732-6798
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
50658
GA
Other
Enumeration date
03/06/2007
Last updated
06/06/2024
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