Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 125952 | OH |
NPI | 1013159433 |
---|---|
Provider Name | Matthew Joseph Maurice |
First Address | Canton, OH 44708-4698 |
Second Address | Canton, OH 44708-4698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2009 |
Last Update Date | 14/10/2020 |