License holder summary

MAIA MAMAMTAVRISHVILLI is a Medical Physician And Surgeon licensed to practice in Pennsylvania. The address on file for MAIA MAMAMTAVRISHVILLI is NEW YORK NY 10032. This medical practitioner license is not current. The license was granted 11/29/2000 and expired on 12/31/2004.

Department of State

Board of Medicine

MAIA MAMAMTAVRISHVILLI
Medical Physician And Surgeon
License number
MD072639L
Date granted
11/29/2000
Date expires
12/31/2004
Class
Medical Physician And Surgeon
Status
Inactive
Address
NEW YORK NY 10032
medicinepa.com
ID 37647845
LAST UPDATED 2026-06-05 23:03:56 UTC

This website is unaffiliated with the Board of Medicine. Please verify all information directly with the relevant official government authority.

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