Provider Demographics
NPI:1699394874
Name:MAI, ANTHONY P (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:P
Last Name:MAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:65 S MARIO CAPECCHI DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0002
Mailing Address - Country:US
Mailing Address - Phone:801-585-6701
Mailing Address - Fax:
Practice Address - Street 1:3101 W 57TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3162
Practice Address - Country:US
Practice Address - Phone:605-361-3937
Practice Address - Fax:605-371-7199
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD15525207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology