Individual
IAN A MAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455
(612) 672-7422
Mailing address
1755 S GRAND BLVD, DERMATOLOGY, SAINT LOUIS, MO 63104-1540
(314) 256-3430
(314) 256-3421
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
2013018998
MO
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
63602
MN
207NS0135X
Procedural Dermatology Physician
2013018998
MO
Other
Enumeration date
06/12/2008
Last updated
07/23/2018
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