| Doctor Name: | MAIJA BAMFORD |
| NPI Number: | 1144594235 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | COA.12745-NP |
| Business Practice Address: | 590 Newark Granville Rd Granville, OH - 430231436 |
| Business Phone Number: | 8885317444 |
| Business Fax Number: | 7408881374 |
| Mailing Address: | 212e Elm St, GRANVILLE |
| State: | OH |
| Postal Code: | 430231404 |
| Phone Number: | 6142042322 |
| Fax Number: | |
| NPI Enumeration Date: | 03/07/2012 |
| NPI Last Update Date: | 09/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | COA.12745-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |