Provider Demographics
NPI:1437513009
Name:MAGAW, MATTHEW L
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:L
Last Name:MAGAW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 LYNNE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5505
Mailing Address - Country:US
Mailing Address - Phone:330-807-4614
Mailing Address - Fax:
Practice Address - Street 1:2811 LYNNE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5505
Practice Address - Country:US
Practice Address - Phone:330-807-4614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker