=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235122755
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL SUMNER MAHER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2005
-----------------------------------------------------
Last Update Date | 06/21/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10101 N 92ND ST STE 101
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85258-4553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-747-6532
-----------------------------------------------------
Fax | 480-889-6865
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10101 N 92ND ST STE 101
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85258-4553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-747-6532
-----------------------------------------------------
Fax | 480-889-6865
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 20806
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------