Provider Demographics
NPI:1407811011
Name:MAHER, STEVEN F (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:F
Last Name:MAHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:CO
Mailing Address - Zip Code:81643-0316
Mailing Address - Country:US
Mailing Address - Phone:719-293-4122
Mailing Address - Fax:
Practice Address - Street 1:78825 EASTREGAARD RD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OR
Practice Address - Zip Code:97818-9642
Practice Address - Country:US
Practice Address - Phone:719-293-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32203207Q00000X
ORMD156396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01322031Medicaid
COF78195Medicare UPIN
CO01322031Medicaid
F78195Medicare UPIN