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Individual

GERALD S MAXWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5533 MAHONING AVE, AUSTINTOWN, OH 44515-2366
(330) 793-2701
(330) 793-2366
Mailing address
5533 MAHONING AVE, AUSTINTOWN, OH 44515-2366
(330) 793-2701
(330) 793-2366

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-006824
OH
207Q00000X
Family Medicine Physician
OS9661
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2374274
OH
05
2744376-00
FL
Enumeration date
06/17/2005
Last updated
01/11/2021
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