MAXIM A EFREMOV ACNP NPI 1659334423

NPI Information

NPI: 1659334423
Provider Name: MAXIM A EFREMOV, ACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: WAKE FOREST UNIVERSITY HEALTH SCIENCES

PECOS Registration: Yes

Address:
MEDICAL CENTER BLVD
WAKE FOREST UNIVERSITY HEALTH SCIENCES
WINSTON SALEM, NC
ZIP 27157
Phone: (336) 716-2011
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Maxim A Efremov, ACNP is an acute care nurse practitioner in Winston Salem, NC with 21 years of experience. Maxim A Efremov, ACNP NPI is 1659334423. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

MEDICAL CENTER BLVD
WAKE FOREST UNIVERSITY HEALTH SCIENCES
WINSTON SALEM, NC
ZIP 27157-001
Phone: (336) 716-2011

The NPI 1659334423 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/11/2006 and was last updated on 3/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	R45111	NEW MEXICO	No
2	363LA2100X	Nurse Practitioner	Acute Care	CNP01073	NEW MEXICO	No
3	363LA2100X	Nurse Practitioner	Acute Care	5006044	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NPI & TIN	OTHER	NEW MEXICO	BCBS OF NM
2	NCB587B	MEDICARE PIN	NORTH CAROLINA
3	NM303052	MEDICARE PIN	NEW MEXICO
4	99609754	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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