Provider Demographics
NPI:1932214350
Name:MAYS, DARLA DAWN (PA-C)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:DAWN
Last Name:MAYS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DARLA
Other - Middle Name:DAWN
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7445 IRISH RD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48746-9133
Mailing Address - Country:US
Mailing Address - Phone:989-871-4353
Mailing Address - Fax:
Practice Address - Street 1:2180 E OHMER RD
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:MI
Practice Address - Zip Code:48744
Practice Address - Country:US
Practice Address - Phone:989-843-5135
Practice Address - Fax:877-845-1481
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002325363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5601003431OtherSTATE LICENSE
MIR74229Medicare UPIN