Provider Demographics
NPI:1144525999
Name:MAI TING, MD, INC.
Entity type:Organization
Organization Name:MAI TING, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-820-1200
Mailing Address - Street 1:1037 W DON DIEGO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1683
Mailing Address - Country:US
Mailing Address - Phone:505-820-1200
Mailing Address - Fax:
Practice Address - Street 1:1037 W DON DIEGO AVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1683
Practice Address - Country:US
Practice Address - Phone:505-820-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM81-130207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty