If you wish to register as a provider with the MAIB, you will need to provide the following details:

1.  Name of provider

2.  Practice/company name

3.  Postal address

4.  Practice/company address

5.  Email address

6.  Practice/company phone number

7.  Practising speciality (eg GP, physio etc)

8.  Medicare provider number (if applicable)

9.  Australian Business Number (ABN)

10. Bank details (MAIB transmit payments by Electronic Funds Transfer (EFT))

To register as a provider, or to amend your current registration details, please complete the Provider Application Form available in the Resources/Forms section of this site.