Individual
GINA M MAXEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1862 AUBURN RD, DACULA, GA 30019-1676
(678) 288-4142
(678) 288-4143
Mailing address
1862 AUBURN RD, DACULA, GA 30019-1676
(678) 288-4142
(678) 288-4143
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
056136
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110257A
—
GA
Enumeration date
12/12/2006
Last updated
08/21/2015
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