MEDICARE: DR. MAURICE MILTON CULVER 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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	G53021	CA

General Provider Information

NPI Number	:	1407159957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAURICE MILTON CULVER M.D.

Provider Business Mailing Address
First Line	:	5608 CREST CREEK DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5358
Country	:	US
Telephone Number	:	904-553-3442
Fax Number	:

Provider Business Practice Location Address
First Line	:	5608 CREST CREEK DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5358
Country	:	US
Telephone Number	:	904-553-3442
Fax Number	:

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

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	12/06/2010

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