Provider Demographics
NPI:1013025857
Name:MAI, JEFFREY CHING-KWEI (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CHING-KWEI
Last Name:MAI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 79777
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0777
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:434-654-7752
Practice Address - Street 1:500 MARTHA JEFFERSON DR
Practice Address - Street 2:5TH FLOOR
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4668
Practice Address - Country:US
Practice Address - Phone:434-654-5260
Practice Address - Fax:434-654-5261
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101253988207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVD095BMedicare PIN
VAP01819782Medicare PIN