Individual
DR. MAMON Y MAITEH
Active
Individual
DR. MAMON Y MAITEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301079222
MI
2084N0400X
Neurology Physician
Primary
2007001624
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4746015
—
MI
Enumeration date
02/02/2006
Last updated
09/15/2010
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