Provider Demographics
NPI:1770603946
Name:HIGHTOWER, MAIA H (MD MPH)
Entity type:Individual
Prefix:
First Name:MAIA
Middle Name:H
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5137
Mailing Address - Country:US
Mailing Address - Phone:510-409-9274
Mailing Address - Fax:
Practice Address - Street 1:570 ASPEN DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5137
Practice Address - Country:US
Practice Address - Phone:510-409-9274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2025-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-43004207R00000X
UT11433706-1205207R00000X
CAA91910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91910OtherCAL ST LIC
IAMD-43004OtherIOWA BOARD OF MEDICINE