| NPI Details | |
|---|---|
| NPI | 1063802023 |
| Gender | Male |
| Enumeration Date | 01/29/2015 |
| Last Updated | 01/29/2015 |
| Entity Type | Individual |
| Active | Over 3 years ago |
| Practice Location | |
|---|---|
| 3417 MERLIN DR SUITE 102 IDAHO FALLS ID, 83404-7430, US |
|
| Phone | (208) 552-0850 |
| Fax | |
| Business Location | |
|---|---|
| 1995 BENGAL VIEW DR POCATELLO ID, 83201-4994, US |
|
| Phone | (858) 405-5529 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 103T00000X |
| License State | |
| License Number | |
| Remove 1063802023 NPI Number | |
According to our database, Maxwell Moholy M.S. NPI is 1063802023, taxonomy code is 103T00000X Maxwell Moholy M.S. physically located at 3417 Merlin Dr, Idaho Falls ID, 83404-7430. NPI Number Maxwell Moholy M.S. has the Individual type.
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1063802023 NPI number is provided on an as is basis without warranty of any kind. 1063802023 is maintained by the National Plan & Provider Enumeration System. The contents of Maxwell Moholy M.S. are for informational purposes only.
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