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NPI Code Detail

MEDICARE: MIGUEL ANGEL MATURANA GONZALEZ MD

MEDICARE: MIGUEL ANGEL MATURANA GONZALEZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0001XClinical Cardiac Electrophysiology Physician63524TN
2390200000XStudent in an Organized Health Care Education/Training Program
3207R00000XInternal Medicine Physician63524TN

General Provider Information

NPI Number : 1457849713
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIGUEL ANGEL MATURANA GONZALEZ MD
Provider Business Mailing Address
First Line : 8060 WOLF RIVER BLVD
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1727
Country : US
Telephone Number : 901-271-1000
Fax Number : 901-271-4187
Provider Business Practice Location Address
First Line : 6565 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2703
Country : US
Telephone Number : 713-790-3311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2018
Last Update Date : 05/28/2026

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