Basic Information
| Provider Information | |||||||||
| NPI: | 1700867504 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAUL | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 ADAMS ST | ||||||||
| Address2: | |||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283072002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104364641 | ||||||||
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| Practice Location | |||||||||
| Address1: | WOMACK ARMY MEDICAL CENTER | ||||||||
| Address2: | 2817 REILLY ROAD | ||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283100001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109078447 | ||||||||
| FaxNumber: | 9109078473 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| 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 | 207Q00000X | DO11649 | OR | X | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 21023 | CO | X | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS9056 | FL | X | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.