Healthcare Provider Details

I. General information

NPI: 1649338310
Provider Name (Legal Business Name): LOUIS MAGGIORE, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25100 EUCLID AVE SUITE 112
EUCLID OH
44117-2648
US

IV. Provider business mailing address

25100 EUCLID AVE SUITE 112
EUCLID OH
44117-2648
US

V. Phone/Fax

Practice location:
  • Phone: 216-731-9215
  • Fax: 216-731-5456
Mailing address:
  • Phone: 216-731-9215
  • Fax: 216-731-5456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY JOHN MORLEY
Title or Position: CEO
Credential: MD
Phone: 216-731-9215