Provider Demographics
NPI:1356070130
Name:COFIELD, MARIA M
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:M
Last Name:COFIELD
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 1:2694 SILVER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-8793
Mailing Address - Country:US
Mailing Address - Phone:252-702-5133
Mailing Address - Fax:
Practice Address - Street 1:2694 SILVER CREEK DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-8793
Practice Address - Country:US
Practice Address - Phone:252-702-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X
NC8376075172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver