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NPI Code Detail

MEDICARE: MICHAEL S MAXWELL M.D.

MEDICARE: MICHAEL S MAXWELL M.D.
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
1207Q00000XFamily Medicine PhysicianMD00027845WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558393231
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL S MAXWELL M.D.
Provider Business Mailing Address
First Line : 240 W FRONT ST STE A
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-2609
Country : US
Telephone Number : 360-452-7891
Fax Number : 360-452-8087
Provider Business Practice Location Address
First Line : 240 W FRONT ST STE A
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-2609
Country : US
Telephone Number : 360-452-7891
Fax Number : 360-452-8087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 02/17/2023

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Directions to “ MICHAEL S MAXWELL M.D.” Practice Location

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