Healthcare Provider Details

I. General information

NPI: 1124277900
Provider Name (Legal Business Name): JOHN EARL MAYE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 NORTHVIEW TER
ROCHESTER NY
14621-3125
US

IV. Provider business mailing address

57 NORTHVIEW TER
ROCHESTER NY
14621-3125
US

V. Phone/Fax

Practice location:
  • Phone: 585-647-6525
  • Fax:
Mailing address:
  • Phone: 585-647-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number165650
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: