Provider Demographics
NPI:1558987388
Name:ATTERBERRY, MARIAH (CCMA, CPT)
Entity Type:Individual
Prefix:MRS
First Name:MARIAH
Middle Name:
Last Name:ATTERBERRY
Suffix:
Gender:F
Credentials:CCMA, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 SHIPMANS PIKE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-9285
Mailing Address - Country:US
Mailing Address - Phone:910-381-6388
Mailing Address - Fax:
Practice Address - Street 1:214 SHIPMANS PIKE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-9285
Practice Address - Country:US
Practice Address - Phone:910-381-6388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPK2Q6F7R5246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy