Provider Demographics
NPI:1740239714
Name:MAYLE, JAMES E (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:MAYLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:A201
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:1210 W SAGINAW ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1927
Practice Address - Country:US
Practice Address - Phone:517-364-7575
Practice Address - Fax:517-364-7560
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2016-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIJM039364207RG0100X
MI4301039364207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1740239714Medicaid
MIC36088104Medicare PIN
MI1740239714Medicaid
MIC36088104Medicare PIN