Individual provider · Type 1 NPI

Nicolas Katkhordeh Maynard, MD

Student in an Organized Health Care Education/Training Program · St. Louis, MO

NPI number 1134814726 Active

Practice location

1402 S Grand Blvd Rm M260
St. Louis, MO 63104-1004

Call (314) 617-2359 Map

Other practice locations

  • 2335 Stockton Blvd, North Addition 5th Floor, Sacramento, CA 95817 · (916) 734-2816

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1134814726

Nicolas Katkhordeh Maynard, MD's National Provider Identifier is 1134814726, issued on Apr 10, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in St. Louis, MO. The record was last updated on Jun 25, 2024.