DR. WALISA K MAYNARD (NPI# 1609906973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609906973 |
| Entity Type | Individual |
| Full Name | DR. WALISA K MAYNARD |
| Credential | M.D. |
| Practice Address |
4040 Hospital West Dr Austell GA 30106-8117 |
| Practice Telephone | 7707326798 |
| Mailing Telephone | 7707326798 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2010-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
050658 | GA | Allopathic & Osteopathic Physicians |
| N | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
50658 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
4040 HOSPITAL WEST DR |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-8117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407811060 | Wellstar Community Hospice, LLC | Hospice Care, Community Based | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2006-04-18 |
| 1528322534 | Kristian Holmes Stodghill | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2012-06-25 |
| 1942593959 | Wellstar Medical Group, LLC | Family Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2011-05-24 |
| 1164725776 | Denise J. Wright | Nurse Practitioner | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2010-12-21 |
| 1770803942 | Manouchka Tulia Joseph | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2010-06-10 |
| 1093042822 | Lashonte Thomas-shaw | Nurse Practitioner | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2009-11-16 |
| 1811135056 | Pamela Gordon | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2009-01-27 |
| 1063680049 | Wellstar Palliative Medicine, LLC | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2008-02-13 |
| 1396966016 | Anjali Parmar Grandhige | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2007-05-01 |
| 1376767731 | Glenora Mccoy | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2007-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710545553 | Palcare Health LLC | Internal Medicine | 1315 Merry Ln Ne, Atlanta, GA 30329-3903 | 2019-06-05 |
| 1518334200 | Miguel E Stubbs M D P C | Internal Medicine | 230 Beaver Falls Pl Sw, Atlanta, GA 30331-8326 | 2015-08-28 |
| 1497155469 | Golden Geriatrics LLC | Internal Medicine | 632 Vinings Estates Dr Se, Mableton, GA 30126-5991 | 2014-08-27 |
| 1821361577 | Senior Care Office, LLC | Internal Medicine | 2020 Beverly Road, Gainesville, GA 30501-2037 | 2012-02-10 |
| 1609162965 | Linduc PC | Internal Medicine | 2680 Lawrenceville Hwy Ste 202, Decatur, GA 30033-2526 | 2011-06-24 |
| 1447574918 | David L. Anders, M.d., P.C. | Internal Medicine | 101 Mcwilliams Dr, Peachtree City, GA 30269-6948 | 2010-03-26 |
| 1639319502 | New Snellville Clinic | Internal Medicine | 2331 Henry Clower Blvd, Suite A, Snellville, GA 30078-3155 | 2009-03-04 |
| 1952557977 | Diego Hernando Remolina | Internal Medicine | 49 Jesse Hill Jr Dr Se Rm 471, Atlanta, GA 30303 | 2008-08-11 |
| 1912165192 | Aristotle Cochon | Internal Medicine | 955 Lynn Dr, Waycross, GA 31503-8590 | 2008-05-25 |
| 1972792265 | Perimeter Medical Associates,p.c. | Internal Medicine | 3775 N. Druid Hills Rd, Decatur, GA 30033 | 2007-10-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.