MEDICARE: DR. ARUP MAITRA 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
1	174400000X	Specialist	3577507	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1760473763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARUP MAITRA MD

Provider Business Mailing Address
First Line	:	2600 TUSCARAWAS ST W
Second Line	:	#160
City	:	CANTON
State	:	OH
Zip	:	44708-4644
Country	:	US
Telephone Number	:	330-454-9126
Fax Number	:	330-454-9470

Provider Business Practice Location Address
First Line	:	2600 TUSCARAWAS ST W
Second Line	:	#160
City	:	CANTON
State	:	OH
Zip	:	44708-4644
Country	:	US
Telephone Number	:	330-454-9126
Fax Number	:	330-454-9470

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	07/09/2012

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Directions to “ DR. ARUP MAITRA MD” Practice Location

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