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General NPI Number Information
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NPI Number | 1780976266
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Entity Type | Individual
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Provider Name | CLAYTON MICHAEL MARAIST M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 2309 E MAIN ST SUITE 200
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City | NEW IBERIA
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State | LA
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Zip | 70560-4046
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Country | US
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Telephone | 337-256-8779
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Fax | 337-359-4997
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Provider Business Mailing Address
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Address Line | PO BOX 12137
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City | NEW IBERIA
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State | LA
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Zip | 70562-2137
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Country | US
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Telephone | 337-256-8779
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Fax | 337-359-4997
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD.207826
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License Number State | LA
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