Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 4301087405 | MI |
NPI | 1043229073 |
---|---|
Provider Name | Cormac Oliver Maher |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 31/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H03216 | (02) | MI |