Provider Demographics
NPI:1790181444
Name:MAYAKIS, CALLIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CALLIE
Middle Name:
Last Name:MAYAKIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 PENINSULA DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7060
Mailing Address - Country:US
Mailing Address - Phone:704-892-5814
Mailing Address - Fax:704-896-9826
Practice Address - Street 1:431 PENINSULA DR
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-7060
Practice Address - Country:US
Practice Address - Phone:704-892-5814
Practice Address - Fax:704-896-9826
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist