Provider Demographics
NPI:1194835637
Name:MAHER, WILLIAM STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:MAHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 546
Mailing Address - City:NEWTON LOWER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-964-5020
Mailing Address - Fax:617-964-3033
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 546
Practice Address - City:NEWTON LOWER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-964-5020
Practice Address - Fax:617-964-3033
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA78946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3198600Medicaid
MA400623OtherTUFTS HEALTH PLAN
MA0407539OtherUNITED HEALTHCARE
MA6000021OtherHARVARD PILGRIM HEALTHCAR
MAJ21520OtherBLUE SHIELD
MA1013478004OtherCIGNA HEALTHCARE
MAP00079305OtherRAILROAD MEDICARE
MA400623OtherTUFTS HEALTH PLAN
MAG96621Medicare UPIN
MA6000021OtherHARVARD PILGRIM HEALTHCAR