Provider Demographics
NPI:1669549986
Name:MAHER, JONATHAN R (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:R
Last Name:MAHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5715
Mailing Address - Fax:
Practice Address - Street 1:2900 LAMB CIR # L-760
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6344
Practice Address - Country:US
Practice Address - Phone:540-731-2436
Practice Address - Fax:540-731-2439
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238594207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1669549986OtherHEALTHKEEPERS PLUS
VA1669549986OtherUMWA
VA1669549986OtherCIGNA
VA1669549986OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1669549986OtherINTOTAL
VA3810029560OtherMEDICAID OF WEST VIRGINIA
VA1669549986OtherUNITED HEALTHCARE
VA1669549986OtherANTHEM BCBS
VA1669549986OtherVA PREMIER
VA1669549986OtherTRICARE
VA1669549986OtherGATEWAY
VAP01563951OtherRAILROAD MEDICARE
VA1669549986OtherHUMANA MEDICARE
VA1669549986OtherVIRGINIA HEALTH NETWORK
VA1669549986OtherHEALTHKEEPERS
VA1669549986OtherAETNA
VA1669549986OtherOPTIMA HEALTH PLAN
VA1669549986Medicaid
VA1669549986OtherOPTIMA HEALTH PLAN