Provider Demographics
NPI:1326245895
Name:MAIBERGER, MARY PIAZZA (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:PIAZZA
Last Name:MAIBERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6163 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3901
Mailing Address - Country:US
Mailing Address - Phone:301-984-3000
Mailing Address - Fax:301-984-3001
Practice Address - Street 1:6163 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3901
Practice Address - Country:US
Practice Address - Phone:301-984-3000
Practice Address - Fax:301-984-3001
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD72837207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology