Provider Demographics
NPI:1437686516
Name:MAGEE, MAXWELL RALEIGH
Entity Type:Individual
Prefix:
First Name:MAXWELL
Middle Name:RALEIGH
Last Name:MAGEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 UNIVERSITY AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8206
Mailing Address - Country:US
Mailing Address - Phone:515-241-2200
Mailing Address - Fax:
Practice Address - Street 1:6000 UNIVERSITY AVE STE 203
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8206
Practice Address - Country:US
Practice Address - Phone:515-241-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-52582207V00000X
KS04-44451207V00000X
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program