Provider Demographics
NPI:1326625229
Name:MAHER, COLLEEN RUTH (DO)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:RUTH
Last Name:MAHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21201 E SADDLE ROCK LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2652
Mailing Address - Country:US
Mailing Address - Phone:303-999-9249
Mailing Address - Fax:
Practice Address - Street 1:1411 S POTOMAC ST STE 330
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4539
Practice Address - Country:US
Practice Address - Phone:720-874-2411
Practice Address - Fax:720-476-3369
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0008553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine