Organization
PHILLIP MAIDEN M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP G MAIDEN M.D. (OWNER)
(330) 758-4515
Entity
Organization
Contact information
Practice address
1704 NORTH RD SE, WARREN, OH 44484-2958
(330) 707-0610
(330) 758-2862
Mailing address
PO BOX 5384, POLAND, OH 44514-0384
(330) 758-4515
(330) 758-2862
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35063252M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2992047
—
OH
Enumeration date
05/01/2006
Last updated
08/22/2020
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