Provider Demographics
NPI:1124357561
Name:MAIZELS, MAX SAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:SAM
Last Name:MAIZELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:328 OAK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1656
Mailing Address - Country:US
Mailing Address - Phone:804-282-0064
Mailing Address - Fax:804-741-6056
Practice Address - Street 1:328 OAK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1656
Practice Address - Country:US
Practice Address - Phone:804-282-0064
Practice Address - Fax:804-741-6056
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101027806207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology