Maurice W Stutzman, MD

Individual provider Active NPI Family Medicine Physician · Berlin, OH

NPI 1144201666 · NPPES record last updated Dec 5, 2007

Key facts

NPI
1144201666
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
35048434 (OH)
Practice address
4907A Dalbey Lane
Berlin, OH 44610
Phone
(330) 893-2341
Fax
(330) 893-3027
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35048434 OH Yes

Addresses

Primary practice location

4907A Dalbey Lane
Berlin, OH 44610

Mailing address

PO Box 366
4907A Dalbey Lane
Berlin, OH 44610-0366
Phone (330) 893-2341

Other identifiers

IdentifierTypeStateIssuer
0552576MedicaidOH

Other providers in Berlin, OH

All providers in Berlin, OH · Family Medicine Physician in Ohio

Sources for this page

Verify at the official NPI Registry.