Provider Demographics
NPI:1649754441
Name:STEVEN R MAYNARD, MD, PLLC
Entity Type:Organization
Organization Name:STEVEN R MAYNARD, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-272-8061
Mailing Address - Street 1:1901 S UNION AVE STE B3010
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1803
Mailing Address - Country:US
Mailing Address - Phone:253-383-5628
Mailing Address - Fax:253-383-5687
Practice Address - Street 1:1901 S UNION AVE STE B3010
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1803
Practice Address - Country:US
Practice Address - Phone:253-383-5628
Practice Address - Fax:253-383-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty