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Individual
MRS. PAULA B MAHAN
Active
Individual
MRS. PAULA B MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004614
GA
363A00000X
Physician Assistant
Primary
PA9110244
FL
363AS0400X
Surgical Physician Assistant
PA9110244
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020397700
—
FL
01
—
GLTF8
BCBS
FL
01
—
IX801Z
MEDICARE
FL
Enumeration date
06/06/2006
Last updated
03/29/2021
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