Provider Demographics
NPI:1891418562
Name:MAI, MICHELLE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:MAI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 S DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-6523
Mailing Address - Country:US
Mailing Address - Phone:720-412-7347
Mailing Address - Fax:
Practice Address - Street 1:5600 S QUEBEC ST STE 312A
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2208
Practice Address - Country:US
Practice Address - Phone:303-953-5643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant