Individual
MAKSIM EFREMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8200
Mailing address
2016 HIGH VISTA DR, LAKELAND, FL 33813-3074
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP130739
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75-2668015
—
TX
Enumeration date
04/06/2016
Last updated
11/22/2021
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