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1619019304
MICHAEL MAITAR
CARBONDALE, IL
NPI
1619019304
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RG0100X Internal Medicine, Gastroenterology
(Licence: IL 036081217)
Enumeration Date
2007-02-12
Last Update Date
2018-09-25
Business Address
MICHAEL MAITAR MD
2601 W MAIN ST
CARBONDALE, IL 62901
Phone number: 773-519-0911
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Mailing Address
MICHAEL MAITAR MD
1236 E MAIN ST
CARBONDALE, IL 62901-3115
Phone number: 618-457-5200
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