Basic Information
| Provider Information | |||||||||
| NPI: | 1740286731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAI | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2828 CROASDAILE DR | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277052505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8777511157 | ||||||||
| FaxNumber: | 9194251564 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 NW 95TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331502038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058356191 | ||||||||
| FaxNumber: | 3056943649 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2005 | ||||||||
| LastUpdateDate: | 02/14/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | ME87492 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.