Individual
DR. MARTIN RAY MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0803000101
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110394
VALUE OPTIONS
VA
01
—
204047
ANTHEM
VA
Enumeration date
10/17/2006
Last updated
07/08/2007
Update your record
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