MEDICARE: MAYA REISER M.D.

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
1	2085R0202X	Diagnostic Radiology Physician	D0038101	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710923057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYA REISER M.D.

Provider Business Mailing Address
First Line	:	4110 ASPEN HILL RD
Second Line	:	SUITE 200
City	:	ROCKVILLE
State	:	MD
Zip	:	20853-2853
Country	:	US
Telephone Number	:	301-438-5150
Fax Number	:

Provider Business Practice Location Address
First Line	:	11120 NEW HAMPSHIRE AVE
Second Line	:	SUITE 103
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2633
Country	:	US
Telephone Number	:	301-681-7600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	12/20/2013

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