Provider Demographics
NPI:1235292038
Name:MAIA, PAUL S (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:MAIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 EDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-2418
Mailing Address - Country:US
Mailing Address - Phone:803-426-1854
Mailing Address - Fax:803-474-4150
Practice Address - Street 1:715 EDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-2418
Practice Address - Country:US
Practice Address - Phone:803-426-1854
Practice Address - Fax:803-474-4150
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
35ZCGDSMedicare ID - Type Unspecified
GAU84259Medicare UPIN