Provider Demographics
NPI:1194918565
Name:MAHER, CHRISTOPHER C (MED, BC-HIS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:C
Last Name:MAHER
Suffix:
Gender:M
Credentials:MED, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2648 VIRGINIA BEACH BLVD
Mailing Address - Street 2:STE. A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7648
Mailing Address - Country:US
Mailing Address - Phone:757-431-1999
Mailing Address - Fax:757-431-1887
Practice Address - Street 1:2648 VIRGINIA BEACH BLVD
Practice Address - Street 2:STE. A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7648
Practice Address - Country:US
Practice Address - Phone:757-431-1999
Practice Address - Fax:757-431-1887
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101-001497237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist