Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 113618 | FL |
Y | 207X00000X | Orthopaedic Surgeon | 13036 | ND |
N | 207X00000X | Orthopaedic Surgeon | 24653 | NE |
NPI | 1003902354 |
---|---|
Provider Name | Dr. Matthew Christopher Mai |
First Address | Eglin Afb, FL 32542-1302 |
Second Address | Fort Walton Beach, FL 32547-6706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 27/04/2018 |