Provider Demographics
NPI:1205698933
Name:MAIRA, CLAUDIA (PAC)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:MAIRA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8029
Mailing Address - Country:US
Mailing Address - Phone:770-517-6636
Mailing Address - Fax:770-517-6568
Practice Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 180
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8029
Practice Address - Country:US
Practice Address - Phone:770-517-6636
Practice Address - Fax:770-517-6568
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA11946363A00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant