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Individual

KERRY ELIZABETH MAHAN

Active
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Individual

KERRY ELIZABETH MAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M0476
TX
208M00000X
Hospitalist Physician
Primary
E-2055
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137704001
—
AR
05
—
170823201
—
TX
05
—
170823203
—
TX
05
—
170823204
—
TX
05
—
170823205
—
TX
05
—
170823206
—
TX
Enumeration date
04/11/2006
Last updated
11/09/2020
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