Individual
TIMOTHY JAMES MAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(414) 389-2131
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 948-7385
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
63558
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042545
—
WI
Enumeration date
04/10/2013
Last updated
10/09/2023
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