Provider Demographics
NPI:1962597997
Name:MAURER, ANGELA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MARIE
Last Name:MAURER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 SILVER LAKE RD NE
Mailing Address - Street 2:UNIT 100
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-4574
Mailing Address - Country:US
Mailing Address - Phone:612-789-1700
Mailing Address - Fax:
Practice Address - Street 1:3805 SILVER LAKE RD NE UNIT 400
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-4226
Practice Address - Country:US
Practice Address - Phone:612-789-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor