Basic Information
| Provider Information | |||||||||
| NPI: | 1982224747 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MENDELAW | ||||||||
| FirstName: | MAYA | ||||||||
| MiddleName: | AHRONOVICH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | N2198, CB7010, UNC HOSPITALS | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199665136 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | N2198 UNC HOSPITALS CB# 7010 | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199665136 | ||||||||
| FaxNumber: | 9849744873 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2020 | ||||||||
| LastUpdateDate: | 04/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 261613 | NC | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.