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NPI Code Detail

MEDICARE: SUSAN J MATURLO MD

MEDICARE: SUSAN J MATURLO 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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician3562891205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1QM0000000062OTHERUTALTIUS
2344542OTHERUTDMBA
349453OTHERUTPEHP
4990014449OTHERUTPALMETTO GBA
5107008206101OTHERUTIHC HEALTHPLANS
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7870281028MA1OTHERUTEMIA

General Provider Information

NPI Number : 1023076460
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN J MATURLO MD
Provider Business Mailing Address
First Line : 2874 N CARSON ST
Second Line : SUITE 120
City : CARSON CITY
State : NV
Zip : 89706-0251
Country : US
Telephone Number : 775-445-7170
Fax Number : 775-687-8457
Provider Business Practice Location Address
First Line : 2874 N CARSON ST
Second Line : SUITE 120
City : CARSON CITY
State : NV
Zip : 89706-0251
Country : US
Telephone Number : 775-445-7170
Fax Number : 775-687-8457
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 03/28/2016

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Directions to “ SUSAN J MATURLO MD” Practice Location

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