Provider Demographics
NPI:1578610747
Name:MAHER, RACHEL A (DMD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:A
Last Name:MAHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 FOULK ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-475-7640
Mailing Address - Fax:
Practice Address - Street 1:2036 FOULK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3648
Practice Address - Country:US
Practice Address - Phone:302-475-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00011421223P0221X
PADS030908L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE05434Medicare UPIN
DE1000024369Medicare ID - Type Unspecified