Individual
MR. BRIAN SCOTT MAIELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC, CSCS
Contact information
Practice address
19485 OLD JETTON RD, SUITE 210, WINSTON SALEM, NC 27104-3769
(704) 316-1830
(704) 316-1835
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 768-9535
(336) 768-4155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07061
NC
363A00000X
Physician Assistant
011977
NY
Other
Enumeration date
05/05/2008
Last updated
10/26/2020
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