Wally Sherman Mahar, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301030215 Issued in MI

Practice address

21 Midland St
Highland Park, MI 48203-3727

Phone

(248) 698-2094

Fax

(877) 218-9387

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wally S. Mahar, M.D. P.L.L.C.

  • Family Medicine Physician
  • Highland Park, MI
  • NPI 1578862645
  Medicare reassignment NPD Authorized official
• Doctors on Call P.C.

  • Specialist
  • Southfield, MI
  • NPI 1992861124
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1790730497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MIDLAND ST",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033727",
            "telephone_number": "586-556-1997",
            "fax_number": "313-731-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MIDLAND ST",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033727",
            "telephone_number": "248-698-2094",
            "fax_number": "877-218-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAR",
        "first_name": "WALLY",
        "middle_name": "SHERMAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301030215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Gabriel Livingston, DDS
• Ronald Anthony Livingston, DDS
• Eric Bernard Lowery
• Juliet Namugga Lukwago
• Maat-Pros
• Olivia Maleckas
• Mara Venture Capital LLC
• Mary Marshall, FAODP
• Margo Martin, CAC-M
• Crystal L Mathis

• General Practice Physician in Highland Park, MI
• Providers in Highland Park, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.