Healthcare Provider Details

I. General information

NPI: 1134899149
Provider Name (Legal Business Name): DONOVAN MAISEL PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOSEPH DONOVAN MAISEL PSYD

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 BESTGATE RD STE 325
ANNAPOLIS MD
21401-4291
US

IV. Provider business mailing address

810 BESTGATE RD STE 325
ANNAPOLIS MD
21401-4291
US

V. Phone/Fax

Practice location:
  • Phone: 443-906-3506
  • Fax:
Mailing address:
  • Phone: 443-906-3506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number06681
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: