Basic Information
Provider Information
NPI: 1659365807
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAHER
FirstName: TERENCE
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 11157
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641190157
CountryCode: US
TelephoneNumber: 9132341350
FaxNumber: 9132341108
Practice Location
Address1: 2800 CLAY EDWARDS DR
Address2:  
City: NORTH KANSAS CITY
State: MO
PostalCode: 641163220
CountryCode: US
TelephoneNumber: 8163467220
FaxNumber: 8163467242
Other Information
ProviderEnumerationDate: 09/02/2005
LastUpdateDate: 03/26/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X2005014690MOY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
3585701601MOBCBS KC MOOTHER
P0024015601 RR MEDICARE GROUP CD1534OTHER


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