MEDICARE: ROBERT MALTZ 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	207Y00000X	Otolaryngology Physician	35026004	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000006940	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700874989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MALTZ MD

Provider Business Mailing Address
First Line	:	PO BOX 640716
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45264-0001
Country	:	US
Telephone Number	:	800-357-5728
Fax Number	:	937-291-2962

Provider Business Practice Location Address
First Line	:	10496 MONTGOMERY RD
Second Line	:	STE. 206
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5223
Country	:	US
Telephone Number	:	513-984-1190
Fax Number	:

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	07/08/2007

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