Provider Demographics
NPI:1578308953
Name:MAHER, BRENNAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRENNAN
Middle Name:
Last Name:MAHER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 GEORGETOWN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6422
Mailing Address - Country:US
Mailing Address - Phone:443-531-5888
Mailing Address - Fax:410-877-2002
Practice Address - Street 1:6300 GEORGETOWN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6422
Practice Address - Country:US
Practice Address - Phone:443-531-5888
Practice Address - Fax:410-877-2002
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist