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1114026721

NPI Code Detail

MEDICARE: DR. MAXIMO B LOCKWARD MD

MEDICARE: DR. MAXIMO B LOCKWARD 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
1	2084P0800X	Psychiatry Physician	T-0818	NH
2	2084P0800X	Psychiatry Physician	LT3560	NH
3	2084P0800X	Psychiatry Physician	MD052597L	PA
4	2084P0800X	Psychiatry Physician	4301116510	MI
5	2084P0800X	Psychiatry Physician	35.071065	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	815676	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1114026721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAXIMO B LOCKWARD MD

Provider Business Mailing Address
First Line	:	720 PRESIDENTIAL DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-5792
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7580 NORTHCLIFF AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-3270
Country	:	US
Telephone Number	:	216-206-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	12/06/2022

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Directions to “ DR. MAXIMO B LOCKWARD MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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