Individual
DR. MICHAEL W. MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-1208
(254) 724-2111
Mailing address
PO BOX 840003, DALLAS, TX 75284-0003
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J8661
TX
207Q00000X
Family Medicine Physician
J8661
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134279205
—
TX
05
—
134279208
—
TX
01
—
930048391
RAILROAD MEDICARE
—
Enumeration date
09/16/2005
Last updated
01/28/2022
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