MEDICARE: DR. JAMES E MAYLE 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
1	207RG0100X	Gastroenterology Physician	JM039364	MI
2	207R00000X	Internal Medicine Physician	4301039364	MI
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	4301039364	MI

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

General Provider Information

NPI Number	:	1740239714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES E MAYLE MD

Provider Business Mailing Address
First Line	:	804 SERVICE RD
Second Line	:	A201
City	:	EAST LANSING
State	:	MI
Zip	:	48824-7015
Country	:	US
Telephone Number	:	517-884-2976
Fax Number	:	517-432-3928

Provider Business Practice Location Address
First Line	:	1210 W SAGINAW ST
Second Line	:	SECOND FLOOR
City	:	LANSING
State	:	MI
Zip	:	48915-1927
Country	:	US
Telephone Number	:	517-364-7575
Fax Number	:	517-364-7560

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/12/2016

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Directions to “ DR. JAMES E MAYLE MD” Practice Location

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