Provider Demographics
NPI:1669860524
Name:MAWEL, MAURICE (LPN)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:MAWEL
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8319 SUNNYSIDE CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS PARK
Mailing Address - State:VA
Mailing Address - Zip Code:20111-2312
Mailing Address - Country:US
Mailing Address - Phone:804-338-8115
Mailing Address - Fax:
Practice Address - Street 1:6856 EASTERN AVE NW STE 220
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2166
Practice Address - Country:US
Practice Address - Phone:202-545-6980
Practice Address - Fax:877-839-6747
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1005478164W00000X
MDLP45803164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse