Provider Demographics
NPI:1073770426
Name:MAYAUD, CHRISTIAN GEORGES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:GEORGES
Last Name:MAYAUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 HOLME AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2007
Mailing Address - Country:US
Mailing Address - Phone:215-335-6562
Mailing Address - Fax:
Practice Address - Street 1:92 MAIN ST 203
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-7070
Practice Address - Country:US
Practice Address - Phone:914-573-8874
Practice Address - Fax:888-375-3624
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG136048207R00000X
FLME123487207R00000X
NH17714207R00000X
NC2017-00689207R00000X
TXR1987207R00000X
CT55845207R00000X
NY172534207R00000X
IAMD43425207R00000X
OH128699207R00000X
NJ25MA09936500207R00000X
IL036138366207R00000X
MT58678207R00000X
PAMD454952207R00000X
NY172534-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine