MEDICARE: DR. ROBERT STUART MAUPIN D.D.S., P.A.

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	1223G0001X	General Practice Dentistry	11820	MD

General Provider Information

NPI Number	:	1275558124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT STUART MAUPIN D.D.S., P.A.

Provider Business Mailing Address
First Line	:	2750 COLD SATURDAY DR
Second Line	:
City	:	FINKSBURG
State	:	MD
Zip	:	21048-2232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16036 FREDERICK ROAD
Second Line	:
City	:	LISBON
State	:	MD
Zip	:	21765
Country	:	US
Telephone Number	:	410-489-4200
Fax Number	:	410-489-7871

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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