Provider Demographics
NPI:1518773290
Name:VOTAPEK, MAYA
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:VOTAPEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 CHIMES BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-3549
Mailing Address - Country:US
Mailing Address - Phone:317-658-0441
Mailing Address - Fax:
Practice Address - Street 1:1301 CHIMES BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46615-3549
Practice Address - Country:US
Practice Address - Phone:317-658-0441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program