Provider Demographics
NPI:1043391352
Name:HARWOOD, MAURY K (MD)
Entity Type:Individual
Prefix:
First Name:MAURY
Middle Name:K
Last Name:HARWOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:220 STANDIFORD AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1159
Mailing Address - Country:US
Mailing Address - Phone:209-579-5628
Mailing Address - Fax:209-579-5637
Practice Address - Street 1:18181 BUTTERFIELD BLVD
Practice Address - Street 2:STE 100
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-8108
Practice Address - Country:US
Practice Address - Phone:408-778-2663
Practice Address - Fax:408-778-9197
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2018-01-24
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Provider Licenses
StateLicense IDTaxonomies
CAA79199207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00323030OtherRAIL ROAD MEDICARE
CA00A791990OtherBLUE SHIELD
CA608896700OtherDEPT OF LABOR
CA00A791990Medicaid
CA00A791990OtherBLUE SHIELD
CA00A791990Medicaid