MEDICARE: WILLIAM S. MAIGUR, 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	207Q00000X	Family Medicine Physician	MD031259L	PA

General Provider Information

NPI Number	:	1912099235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM S. MAIGUR, MD

Provider Business Mailing Address
First Line	:	1434 MOUNT COBB RD
Second Line	:
City	:	LAKE ARIEL
State	:	PA
Zip	:	18436-3210
Country	:	US
Telephone Number	:	570-752-4308
Fax Number	:

Provider Business Practice Location Address
First Line	:	1434 MOUNT COBB RD
Second Line	:
City	:	LAKE ARIEL
State	:	PA
Zip	:	18436-3210
Country	:	US
Telephone Number	:	570-752-4308
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM S MAIGUR
Credential	:	MD
Telephone Number	:	570-752-4308

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/22/2020

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