Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01056203A | IN |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD22447 | ME |
N | 207YP0228X | Pediatric Otolaryngology | P0440 | TX |
NPI | 1720065295 |
---|---|
Provider Name | Dr. Stephen Maturo |
First Address | Fort Sam Houston, TX 78234-4501 |
Second Address | Portland, ME 04103-1884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 24/05/2019 |