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General NPI Number Information
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NPI Number | 1659149383
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Entity Type | Organization
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Legal Business Name | MAIMON PLLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 611 WATKINS CENTRE PKWY STE 110
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City | MIDLOTHIAN
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State | VA
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Zip | 23114-4404
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Country | US
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Telephone | 804-893-8447
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 OLD GUN RD W
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-2019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZIYA AKTIG
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Credential | MD
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Telephone | 980-250-4759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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