Basic Information
Provider Information
NPI: 1073707378
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAUPIN
FirstName: EMILY
MiddleName: JEAN
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GEIER
OtherFirstName: EMILY
OtherMiddleName: JEAN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: DO
OtherLastNameType: 1
Mailing Information
Address1: 6039 LANCASHIRE TRL
Address2:  
City: LIBERTY TOWNSHIP
State: OH
PostalCode: 450445782
CountryCode: US
TelephoneNumber: 5135054530
FaxNumber:  
Practice Location
Address1: 1 WYOMING ST
Address2:  
City: DAYTON
State: OH
PostalCode: 454092722
CountryCode: US
TelephoneNumber: 9372083356
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/29/2007
LastUpdateDate: 05/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X34.009697OHY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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