Provider Demographics
NPI:1598894479
Name:MAHER, ROGER THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:THOMAS
Last Name:MAHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7031 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2324
Mailing Address - Country:US
Mailing Address - Phone:913-677-3353
Mailing Address - Fax:913-677-1096
Practice Address - Street 1:7031 JOHNSON DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2324
Practice Address - Country:US
Practice Address - Phone:913-677-3353
Practice Address - Fax:913-677-1096
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03374111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0006613Medicare ID - Type Unspecified