Basic Information
| Provider Information | |||||||||
| NPI: | 1013977529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MASLOV | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 545 | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163460545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146776381 | ||||||||
| FaxNumber: | 8146776384 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 PARK WAY | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163462413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146776381 | ||||||||
| FaxNumber: | 8146776384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | MD045086E | PA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.