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NPI Code Detail

MEDICARE: MAYA YOUNG

MEDICARE:   MAYA  YOUNG
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
1247200000XOther Technician

General Provider Information

NPI Number : 1912308602
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA YOUNG
Provider Business Mailing Address
First Line : 12034 ROSEMARY ST
Second Line :
City : DETROIT
State : MI
Zip : 48213-1351
Country : US
Telephone Number : 313-728-5703
Fax Number :
Provider Business Practice Location Address
First Line : 12034 ROSEMARY ST
Second Line :
City : DETROIT
State : MI
Zip : 48213-1351
Country : US
Telephone Number : 313-728-5703
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2014
Last Update Date : 09/12/2014

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Directions to “ MAYA YOUNG ” Practice Location

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