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General NPI Number Information
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NPI Number | 1588919690
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER CHIEN D. MAI, MD,PA
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 821 STATE ROAD 44
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7271
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Country | US
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Telephone | 386-427-3767
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Fax | 386-423-2516
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Provider Business Mailing Address
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Address Line | 821 STATE ROAD 44
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7271
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Country | US
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Telephone | 386-427-3767
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Fax | 386-423-2516
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | CHRISTOPHER CHIEN MAI
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Credential | M.D.
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Telephone | 386-427-3767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME80709
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License Number State | FL
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