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General NPI Number Information
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NPI Number | 1740006105
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Entity Type | Individual
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Provider Name | MAYA CRAIG
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 11935 ABERCORN ST
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City | SAVANNAH
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State | GA
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Zip | 31419-1918
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Country | US
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Telephone | 912-344-3109
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Fax |
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Provider Business Mailing Address
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Address Line | 105 MAPLE CT
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-3893
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Country | US
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Telephone | 470-255-9194
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Fax | 470-255-9194
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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 | 246QM0706X
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Taxonomy Name | Medical Technologist
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | GA
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