Healthcare Provider Details

I. General information

NPI: 1205745874
Provider Name (Legal Business Name): JOAN M MAIAH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7350 VAN DUSEN RD STE 390
LAUREL MD
20707-5231
US

IV. Provider business mailing address

7350 VAN DUSEN RD STE 390
LAUREL MD
20707-5231
US

V. Phone/Fax

Practice location:
  • Phone: 301-604-8000
  • Fax: 301-604-4406
Mailing address:
  • Phone: 301-604-8000
  • Fax: 301-604-4406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR251381
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: