Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | APP-000144069 | OH |
Y | 111NI0900X | Internist | APP-000144069 | OH |
NPI | 1003305939 |
---|---|
Provider Name | Dr. Grace Ann Maltbie |
First Address | Cleveland, OH 44115-3197 |
Second Address | Cleveland, OH 44115-3197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2018 |
Last Update Date | 07/05/2018 |