Provider Demographics
NPI:1275145690
Name:ROLLAND, MAIA ALEXIS
Entity Type:Individual
Prefix:MISS
First Name:MAIA
Middle Name:ALEXIS
Last Name:ROLLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9738 CENTRAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3988
Mailing Address - Country:US
Mailing Address - Phone:240-691-3138
Mailing Address - Fax:
Practice Address - Street 1:453 W 10TH AVE BLDG 306
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-2205
Practice Address - Country:US
Practice Address - Phone:614-292-1706
Practice Address - Fax:614-292-0210
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program