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General NPI Number Information
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NPI Number | 1487286662
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Entity Type | Individual
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Provider Name | CALEB ANDREW MAYES DO
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Gender | Male
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 5116 KISTER AVE
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City | DUGWAY
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State | UT
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Zip | 84022-1097
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Country | US
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Telephone | 435-831-2885
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Fax |
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Provider Business Mailing Address
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Address Line | 650 HUEBNER RD
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City | BETHESDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 130-129-5400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 2448
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License Number State | NE
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