Healthcare Provider Details
I. General information
NPI: 1942576772
Provider Name (Legal Business Name): JACQUELINE YANO MAHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/27/2012
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 CENTER DR RM 8N248 MSC1840 NICHD
BETHESDA MD
20892-4517
US
IV. Provider business mailing address
10 CENTER DR RM 8N248 MSC1840 NICHD
BETHESDA MD
20892-4313
US
V. Phone/Fax
- Phone: 301-451-0398
- Fax:
- Phone: 301-451-0398
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | D0081327 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | MD047567 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: