Healthcare Provider Details

I. General information

NPI: 1376559872
Provider Name (Legal Business Name): WILLIAM E MAHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 12/28/2020
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 DODD DR FL 4
COLUMBUS OH
43210-1257
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4854
  • Fax: 614-293-8102
Mailing address:
  • Phone: 614-293-2594
  • Fax: 614-293-4487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number35046783
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: