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NPI Code Detail

MEDICARE: GARY A MAYMAN MD

MEDICARE: GARY A MAYMAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0202XPediatric Cardiology Physician6097NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3VWCLCQOTHERNVMEDICARE GROUP #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NV1324OTHERBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4XPY121030OTHERMEDI-CAL

General Provider Information

NPI Number : 1700869120
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY A MAYMAN MD
Provider Business Mailing Address
First Line : 3131 LA CANADA ST STE 230
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-2551
Country : US
Telephone Number : 702-732-1290
Fax Number : 702-732-1385
Provider Business Practice Location Address
First Line : 3131 LA CANADA ST STE 230
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-2551
Country : US
Telephone Number : 702-732-1290
Fax Number : 702-732-1385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 03/08/2022

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Directions to “ GARY A MAYMAN MD” Practice Location

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