MEDICARE: DR. DAVID E MAURER M.D.

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	207Y00000X	Otolaryngology Physician	22130	SC

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

General Provider Information

NPI Number	:	1154303881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E MAURER M.D.

Provider Business Mailing Address
First Line	:	2295 HENRY TECKLENBERG DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-7801
Country	:	US
Telephone Number	:	843-766-7103
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 MAIN ST STE 201
Second Line	:
City	:	HILTON HEAD
State	:	SC
Zip	:	29926-6607
Country	:	US
Telephone Number	:	843-682-3955
Fax Number	:	843-682-3956

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	07/06/2017

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