Provider Demographics
NPI:1801354709
Name:MAWHORTER, MICHAEL EVAN (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EVAN
Last Name:MAWHORTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6681 RIDGE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5745
Mailing Address - Country:US
Mailing Address - Phone:216-983-1796
Mailing Address - Fax:216-844-1900
Practice Address - Street 1:6681 RIDGE RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5713
Practice Address - Country:US
Practice Address - Phone:216-983-1796
Practice Address - Fax:216-844-1900
Is Sole Proprietor?:No
Enumeration Date:2019-03-10
Last Update Date:2024-08-12
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Provider Licenses
StateLicense IDTaxonomies
OH35.151120208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology