Healthcare Provider Details

I. General information

NPI: 1023923323
Provider Name (Legal Business Name): DR. ALEXANDER MATURINO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 MAYFAIR ST STE 110
DURHAM NC
27707-6223
US

IV. Provider business mailing address

13204 TOWNFIELD DR
RALEIGH NC
27614-8827
US

V. Phone/Fax

Practice location:
  • Phone: 984-215-5090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberP25226
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: