1003801176 NPI number — JOHN C. MAHER MD

Table of content: JOHN C. MAHER MD (NPI 1003801176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003801176 NPI number — JOHN C. MAHER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAHER
Provider First Name:
JOHN
Provider Middle Name:
C.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003801176
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7000 STONEWOOD DRIVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
WEXFORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15090
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-940-4001
Provider Business Mailing Address Fax Number:
724-940-4036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 DELAFIELD ROAD
Provider Second Line Business Practice Location Address:
200 ST. MARGARET MEDICAL ARTS BLDG. SUITE 2020
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-784-9060
Provider Business Practice Location Address Fax Number:
412-784-0203
Provider Enumeration Date:
09/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD028164E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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