Maurice R Gardner DPM PA

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

MAURICE R GARDNER DPM PA

Practice address

681 Sabattus St
Lewiston, ME 04240-3829

Phone

(207) 784-2042

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Maurice R. Gardner, DPM

Title

Owner

Phone

(207) 784-2042

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1902954522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 SABATTUS ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042403829",
            "telephone_number": "207-784-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 SABATTUS ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042403829",
            "telephone_number": "207-784-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICE R GARDNER DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-784-2042",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121590000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Mastrianno, CRNA
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• Joy P Mazziotti
• John Arthur Mazzola, PHD
• Robert D McArdle, D.O.

• Podiatrist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Podiatrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.