Healthcare Provider Details

I. General information

NPI: 1518378199
Provider Name (Legal Business Name): DALE MAX SAYLES II RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NAVY HILL
SAIPAN MP
96950-8901
US

IV. Provider business mailing address

PO BOX 10001 PMB 853
SAIPAN MP
96950-8901
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-8950
  • Fax:
Mailing address:
  • Phone: 670-285-2175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberLT-1700
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: