Individual
MAPLE T. LANDVOIGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1464 JEFFERSON ST N, LEWISBURG, WV 24901-1380
(304) 645-3220
(844) 479-4545
Mailing address
1464 JEFFERSON ST N, LEWISBURG, WV 24901-1380
(304) 645-3220
(844) 479-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22154
WV
208000000X
Pediatrics Physician
22154
WV
2080P0214X
Pediatric Pulmonology Physician
Primary
22154
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810015441
—
WV
Enumeration date
07/14/2009
Last updated
04/03/2020
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