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General NPI Number Information
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NPI Number | 1801171129
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Entity Type | Individual
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Provider Name | ABIGAEL NYANGANYI MAXWELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 848 ADAMS AVE
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City | MEMPHIS
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State | TN
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Zip | 38103-2816
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Country | US
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Telephone | 901-287-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 1068 CRESTHAVEN RD STE 300
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City | MEMPHIS
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State | TN
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Zip | 38119-0809
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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 |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 052022
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 268847
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 56560
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License Number State | TN
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