Jerald B Maltzman, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301026478 Issued in MI

Practice address

4744 Wendrick Dr
W. Bloomfield, MI 48323

Phone

(248) 855-1114

NPI assigned

Jun 1, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386846574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4744 WENDRICK",
            "city": "W. BLOOMFIELD",
            "state": "MI",
            "postal_code": "48323",
            "telephone_number": "248-855-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4744 WENDRICK DR",
            "city": "W. BLOOMFIELD",
            "state": "MI",
            "postal_code": "48323",
            "telephone_number": "248-855-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTZMAN",
        "first_name": "JERALD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301026478",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C30021",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01021892A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zvi Levran, MD
• Thomas H Li, M.D.
• Mark D Mackey, M.D
• Holly Mahan, PTA
• Ayshia Malik
• MBK PLLC
• Kathy McGee, LLP
• Medical Consultant PLLC
• Donald A. Meier, MD
• Mental Health Professionals, PC

• Diagnostic Radiology Physician in W. Bloomfield, MI
• Providers in W. Bloomfield, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.