Individual
LYNN G MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
34TH STREET & CIVIC CENTER BLVD, SUITE 9329, PHILADELPHIA, PA 19104-4399
(215) 590-1858
(215) 590-1415
Mailing address
100 E PENN SQ, THE WANAMAKER BUILDING, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD419245
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD419245
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD419245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016553470
—
PA
01
—
057804J6Z
MEDICARE PTAN PAIN MANAGEMENT
PA
01
—
198358EJL
MEDICARE PTAN ANESTHESIA
PA
Enumeration date
08/15/2006
Last updated
04/17/2013
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