Terrance Alexander Mayes, IDC
Military Health Care Provider, Independent Duty Corpsman in San Diego, CA. Individual provider (NPI-1).
NPI number1801239504
StatusActive
Last updated in NPPESApr 11, 2013
Details
- NPI
- 1801239504
- Entity type
- Individual (NPI-1)
- Name
- Terrance Alexander Mayes
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 11, 2013
- Last updated
- Apr 11, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Practice location
34101 Farenholt AveSan Diego, CA 92134-7000
Phone 404-441-0180
Mailing address
2791 Deerwood Ln SwAtlanta, GA 30331-5584
Phone 404-441-0180
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