Healthcare Provider Details

I. General information

NPI: 1275697815
Provider Name (Legal Business Name): JAMES HOWARD MAURER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 BERLEKAMP DR
SAINT CHARLES MO
63303-5004
US

IV. Provider business mailing address

257 BERLEKAMP DR
SAINT CHARLES MO
63303-5004
US

V. Phone/Fax

Practice location:
  • Phone: 636-947-4766
  • Fax: 636-493-1128
Mailing address:
  • Phone: 636-947-4766
  • Fax: 636-493-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License NumberR6G65
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: