MEDICARE: MILLARD MAZER

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	1223P0300X	Periodontics	9817	MD

General Provider Information

NPI Number	:	1669510285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILLARD MAZER

Provider Business Mailing Address
First Line	:	10630 LITTLE PATUXENT PKWY
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3264
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10630 LITTLE PATUXENT PKWY
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3264
Country	:	US
Telephone Number	:	410-884-1179
Fax Number	:

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

Provider Enumeration Date	:	02/03/2007
Last Update Date	:	04/12/2026

Similar Medicare Providers

1871588707 — DR. JOSEPH ERIC OSHEROFF M.D.
Practice Location Address:

10630 LITTLE PATUXENT PKWY , SUITE 305
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1467490151 — MARILYN YUNK LCSW-C
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Practice Location Address:

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1902907447 — ROBERT J. TEMPLE, MD PA
Practice Location Address:

10630 LITTLE PATUXENT PKWY , SUITE 212
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1871686543 — SAUL NEIL LIEBERMAN PH.D.
Practice Location Address:

10630 LITTLE PATUXENT PKWY , STE 212
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Directions to “ MILLARD MAZER ” Practice Location

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