Organization
BEN R MAYNE III
Active
Organization
BEN R MAYNE III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN R MAYNE III MD (OWNER)
(989) 839-8865
Entity
Organization
Contact information
Practice address
555 W WACKERLY ST, SUITE 2600, MIDLAND, MI 48640-4722
(989) 839-8865
(989) 492-7839
Mailing address
555 W WACKERLY ST, SUITE 2600, MIDLAND, MI 48640-4722
(989) 839-8865
(989) 492-7839
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
BM406830
MI
363A00000X
Physician Assistant
5601003053
MI
363A00000X
Physician Assistant
5601006775
MI
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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