Michelle Marie Maynard, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G87053 Issued in CA

Practice address

2110 Professional Dr
Roseville, CA 95661-3752

Phone

(916) 536-2500

Fax

(916) 780-3904

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Michelle Marie Dodd Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1194733063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 PROFESSIONAL DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613752",
            "telephone_number": "916-536-2500",
            "fax_number": "916-780-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G87053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DODD",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephen D Maxwell, M.D.
• Anna C May, MS
• Charles H. May III, PH.D.
• Connie D May, M.A.
• Hannah Mayer
• Francis Mbella Manga, PMHNP-BC
• Courtney Rae McAlister
• Robert Addison McAuley, M.D.
• Dillon McBride
• Marla McCall, NURSE PRACTITIONER

• Internal Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.