Provider Demographics
NPI:1760078752
Name:MAHAR, CHERYL S
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:S
Last Name:MAHAR
Suffix:
Gender:F
Credentials:
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 71
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-0071
Mailing Address - Country:US
Mailing Address - Phone:207-557-7308
Mailing Address - Fax:207-305-2843
Practice Address - Street 1:300 RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROBBINSTON
Practice Address - State:ME
Practice Address - Zip Code:04671-3220
Practice Address - Country:US
Practice Address - Phone:207-557-7308
Practice Address - Fax:207-305-2843
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker