Individual
DR. MARTIN RAY MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
134 W PICCADILLY STREET, WINCHESTER, VA 22601
(540) 667-1389
(540) 667-1394
Mailing address
134 W PICCADILLY STREET, WINCHESTER, VA 22601
(540) 667-1389
(540) 667-1394
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
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