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General NPI Number Information
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NPI Number | 1578520854
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Entity Type | Organization
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Legal Business Name | MAPLE INTERNAL MEDICINE & PEDIATRICS, PLLC
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 1835 MAPLE RD STE 1
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2780
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Country | US
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Telephone | 716-634-5410
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Fax | 716-634-0430
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Provider Business Mailing Address
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Address Line | 1835 MAPLE RD STE 1
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2780
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Country | US
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Telephone | 716-634-5410
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Fax | 716-634-0430
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. WILLIAM M HARTRICH
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Credential | M.D.
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Telephone | 716-634-5410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NY
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