Healthcare Provider Details

I. General information

NPI: 1750678611
Provider Name (Legal Business Name): MICHAEL S MAHER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9445 E IRONWOOD SQUARE DR SUITE 110
SCOTTSDALE AZ
85258-4574
US

IV. Provider business mailing address

4022 E PRESIDIO ST
MESA AZ
85215-1113
US

V. Phone/Fax

Practice location:
  • Phone: 480-747-6532
  • Fax: 480-889-6865
Mailing address:
  • Phone: 480-985-1093
  • Fax: 480-296-7643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL S MAHER
Title or Position: PRESIDENT
Credential: MD
Phone: 602-256-5666