Individual
MARK A MAIOCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 N 39TH AVE, YAKIMA, WA 98902-6348
(509) 249-1288
(509) 249-6249
Mailing address
611 N 39TH AVE, YAKIMA, WA 98902-6348
(509) 249-1288
(509) 249-6249
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00034907
WA
208M00000X
Hospitalist Physician
MD00034907
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101831
—
WA
Enumeration date
08/04/2006
Last updated
09/20/2011
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