Individual
ETHAN JEROME MALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-6221
Mailing address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-6221
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
LL52379
SC
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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