Provider Demographics
NPI:1508179185
Name:MAURAGAS, MARK MATHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:MATHEW
Last Name:MAURAGAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 LAUREN CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-3635
Mailing Address - Country:US
Mailing Address - Phone:302-750-8084
Mailing Address - Fax:
Practice Address - Street 1:202 LAUREN CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-3635
Practice Address - Country:US
Practice Address - Phone:302-750-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor