Healthcare Provider Details

I. General information

NPI: 1811254311
Provider Name (Legal Business Name): CHERYL LYNN MAIER MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-0001
US

IV. Provider business mailing address

615 MICHAEL ST NE
ATLANTA GA
30322-0001
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-4283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number72960
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number72960
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: