Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 20049 | MD |
NPI | 1093832990 |
---|---|
Provider Name | Mrs. Jessica Lynn Maher |
First Address | Bel Air, MD 21014-2768 |
Second Address | Bel Air, MD 21014-2768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18KB | BLUE CROSS BLUE SHIELD (01) | MD |
51490001 | BLUE CHOICE (01) | MD |
704159 | UNITED HEALTH CARE (01) | MD |
7581819 | AETNA (01) | MD |