Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 0101054397 | VA |
NPI | 1013996669 |
---|---|
Provider Name | Dr. Andrew Maiolo |
First Address | Salem, VA 24153-7357 |
Second Address | Salem, VA 24153-7357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00277015 | MEDICARE RAILROAD (01) | VA |