Provider Demographics
NPI:1164685053
Name:ZACKARY, MAHER JEFFREY S (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHER
Middle Name:JEFFREY S
Last Name:ZACKARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:M JEFFREY
Other - Middle Name:S
Other - Last Name:ZACKARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3373 COMMERCE PKWY
Mailing Address - Street 2:SUITE#3
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7130
Mailing Address - Country:US
Mailing Address - Phone:330-439-4656
Mailing Address - Fax:
Practice Address - Street 1:3373 COMMERCE PKWY
Practice Address - Street 2:SUITE#3
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7130
Practice Address - Country:US
Practice Address - Phone:330-439-4656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46324207LP2900X
OH35094018207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine