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NPI Code Detail

MEDICARE: DR. AMY GATES MAHER D.O.

MEDICARE:  DR. AMY GATES MAHER  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program58.001942OH

General Provider Information

NPI Number : 1144486101
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY GATES MAHER D.O.
Provider Business Mailing Address
First Line : 3842 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1708
Country : US
Telephone Number : 260-437-9500
Fax Number : 260-434-1020
Provider Business Practice Location Address
First Line : 3842 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1708
Country : US
Telephone Number : 260-437-9500
Fax Number : 260-434-1020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2008
Last Update Date : 08/12/2009

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Directions to “ DR. AMY GATES MAHER D.O.” Practice Location

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