Individual
AMY MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
M3317
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127552
SUPERIOR SSI
TX
05
—
192080301
—
TX
05
—
23404752
—
TX
01
—
85616Y
BCBS
TX
01
—
MDM3317TX
WORKERS COMP
TX
Enumeration date
07/12/2006
Last updated
06/25/2008
Update your record
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