Provider Demographics
NPI:1104980663
Name:YOUNG, MAURICE EDGAR (MD)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:EDGAR
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8866 W HILTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-6969
Mailing Address - Country:US
Mailing Address - Phone:480-798-3225
Mailing Address - Fax:
Practice Address - Street 1:9897 W MCDOWELL RD STE 101
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-1621
Practice Address - Country:US
Practice Address - Phone:623-474-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012377022083A0100X, 208D00000X
CAC55463208D00000X
IN01060075A208D00000X
AZ51391208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMC11305Medicare PIN