Provider Demographics
NPI:1538257670
Name:MAURER, STEVEN L (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:MAURER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WILKES BARRE TOWNSHIP BLVD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6704
Mailing Address - Country:US
Mailing Address - Phone:570-822-3212
Mailing Address - Fax:570-970-8715
Practice Address - Street 1:104 WILKES BARRE TOWNSHIP BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6704
Practice Address - Country:US
Practice Address - Phone:570-822-3212
Practice Address - Fax:570-970-8715
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003272L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010600950003Medicaid
PA425318Medicare PIN