Provider Demographics
NPI:1285601476
Name:MAHER, JUDITH ANNE (MD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNE
Last Name:MAHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:ANNE
Other - Last Name:CAPRARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5320 HOAG DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-0615
Mailing Address - Country:US
Mailing Address - Phone:440-934-5566
Mailing Address - Fax:440-934-5577
Practice Address - Street 1:5320 HOAG DR
Practice Address - Street 2:SUITE B
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-0615
Practice Address - Country:US
Practice Address - Phone:440-934-5566
Practice Address - Fax:440-934-5577
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH490242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0526809Medicaid
A15468Medicare UPIN
OHMA0535043Medicare ID - Type Unspecified