Provider Demographics
NPI:1033264528
Name:MAHAR, MEGHAN SPRING (DPT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:SPRING
Last Name:MAHAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:SPRING
Other - Last Name:URCIUOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 4058
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-4058
Mailing Address - Country:US
Mailing Address - Phone:301-262-5852
Mailing Address - Fax:301-262-3173
Practice Address - Street 1:100 WHITE MARSH PARK DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4361
Practice Address - Country:US
Practice Address - Phone:301-262-5852
Practice Address - Fax:301-262-3173
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS429OtherBLUE SHIELD DC
MDKBX3OtherBLUE SHIELD MD
MDG01032Medicare ID - Type Unspecified