Provider Demographics
NPI:1760406458
Name:MAHER, JOSEPH F (MD)
Entity Type:Individual
Prefix:MS
First Name:JOSEPH
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 1:2500 N STATE STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-5615
Mailing Address - Fax:601-984-5689
Practice Address - Street 1:ELM AND CARLTON STREETS
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-5720
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15242207RH0000X
TXH4513207SG0201X
NY304330207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00123593Medicaid
MSP01620001OtherRAILROAD MEDICARE
AL129970Medicaid
AL129970Medicaid
MS302I825706Medicare PIN
MSE02198Medicare UPIN
MS302I827199Medicare PIN