1174888606 NPI number — DR. ERIC MAIORINO M.D.

Table of content: DR. ERIC MAIORINO M.D. (NPI 1174888606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174888606 NPI number — DR. ERIC MAIORINO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAIORINO
Provider First Name:
ERIC
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174888606
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6410 FANNIN ST
Provider Second Line Business Mailing Address:
SUITE 1400
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-3000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-325-7125
Provider Business Mailing Address Fax Number:
713-512-2200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5530 WISCONSIN AVE STE 818
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHEVY CHASE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20815-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-654-5666
Provider Business Practice Location Address Fax Number:
301-654-5552
Provider Enumeration Date:
07/10/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  D0089038 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)