Provider Demographics
NPI:1801289152
Name:DAVID E MAUK DC INC
Entity type:Organization
Organization Name:DAVID E MAUK DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MAUK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-389-5151
Mailing Address - Street 1:1036 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5537
Mailing Address - Country:US
Mailing Address - Phone:740-389-5151
Mailing Address - Fax:740-389-6994
Practice Address - Street 1:1036 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5537
Practice Address - Country:US
Practice Address - Phone:740-389-5151
Practice Address - Fax:740-389-6994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0480886Medicaid
OH350031086OtherRAILROAD MEDICARE
OH000000132604OtherANTHEM
OH4400014OtherUNITED HEALTHCARE
OH000000132604OtherANTHEM
OHMA0499901Medicare PIN