1568858736 NPI number — DR. MARGARET MAULTSBY PARHAM MD

Table of content: DR. MARGARET MAULTSBY PARHAM MD (NPI 1568858736)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568858736 NPI number — DR. MARGARET MAULTSBY PARHAM MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARHAM
Provider First Name:
MARGARET
Provider Middle Name:
MAULTSBY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAULTSBY
Provider Other First Name:
MARGARET
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568858736
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PCS BOX 20137
Provider Second Line Business Mailing Address:
8TH COMM BAS II MEF
Provider Business Mailing Address City Name:
CAMP LEJEUNE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28546-0137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-450-8772
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8TH COMM BAS II MEF
Provider Second Line Business Practice Location Address:
PCS BOX 20137
Provider Business Practice Location Address City Name:
CAMP LEJEUNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28546-0137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-450-8772
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2015

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: 208D00000X , with the licence number:  2016-02537 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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