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Contact Information

JOHN C MAYBERRY, MD
1906 FAIRVIEW AVE STE 130
CALDWELL, ID83605-5433
 Phone: 208-453-4260
 Fax: 844-213-3678
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JOHN C MAYBERRY · (Male)

NPI Number 1528074077
Status Active
Credentials MD
Entity Individual
Enumeration date 08/01/2006
Last updated 10/03/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • ID License # M-12108
Hospital affiliation(s)
  • GROSSMONT HOSPITAL - (Acute Care)
    5555 GROSSMONT CENTER DRIVE BOX 58
    LA MESA, CA 91942
  • WEST VALLEY MEDICAL CENTER - (Acute Care)
    1717 ARLINGTON STREET
    CALDWELL, ID 83605
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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