Individual
DR. MATTHEW TAM MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
20044 CEDAR RD N STE A, SONORA, CA 95370-5900
(209) 536-3750
(209) 532-9811
Mailing address
20044 CEDAR RD N STE A, SONORA, CA 95370-5900
(209) 536-3750
(209) 532-9811
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20A10864
CA
207V00000X
Obstetrics & Gynecology Physician
5101015815
MI
207V00000X
Obstetrics & Gynecology Physician
T-521
NM
Other
Enumeration date
04/16/2007
Last updated
10/10/2009
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