Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maximillian Ly

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114720489

Maximillian Ly is a Student in an Organized Health Care Education/Training Program in Stillwater, Oklahoma. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1323 W 6th Ave
Stillwater, OK 74074-4306
Phone: (405) 372-1480
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1114720489
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedMarch 31, 2025
Last updated in NPPESMarch 31, 2025
Certification dateMarch 31, 2025
Mailing address1323 W 6th Ave, Stillwater, OK 74074-4306

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