Provider Demographics
NPI:1558396044
Name:MAHER, LEO MARIA (MD)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:MARIA
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 1:1600 KAPIOLANI BLVD STE 524
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3805
Mailing Address - Country:US
Mailing Address - Phone:808-545-3299
Mailing Address - Fax:808-545-3133
Practice Address - Street 1:1029 KAPAHULU AVE STE 309
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-545-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43014052662084N0400X
HIMD-65952084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05427301Medicaid
HII-006262-1OtherHMSA PROVIDER NO.
51558Medicare ID - Type Unspecified
HI05427301Medicaid