MEDICARE: DR. MAURICE LOUIS OFFEN 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	2084N0400X	Neurology Physician	D0019083	MD

General Provider Information

NPI Number	:	1558527739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAURICE LOUIS OFFEN MD

Provider Business Mailing Address
First Line	:	141 BETHLEHEM PIKE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-2814
Country	:	US
Telephone Number	:	301-897-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 BETHLEHEM PIKE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-2814
Country	:	US
Telephone Number	:	301-897-0000
Fax Number	:

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

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	05/05/2015

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