Provider Demographics
NPI:1689795270
Name:MAHER, THOMAS D (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:D
Last Name:MAHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1020 SOUTHHILL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8629
Mailing Address - Country:US
Mailing Address - Phone:866-906-1637
Mailing Address - Fax:866-588-0085
Practice Address - Street 1:1020 SOUTHHILL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8629
Practice Address - Country:US
Practice Address - Phone:866-906-1637
Practice Address - Fax:866-588-0085
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY127236207R00000X
WI6037207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00507144Medicaid