Individual
TIMOTHY M MAHOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3219 MERAMEC ST, SAINT LOUIS, MO 63118-4305
(314) 351-2716
(314) 351-1286
Mailing address
3219 MERAMEC ST, SAINT LOUIS, MO 63118-4305
(314) 351-2716
(314) 351-1286
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R8D34
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005020417
AETNA
—
01
—
04-00464
UNITED HEALTH CARE-MCC
—
01
—
131610
BC
—
01
—
152910
HEALTHLINK
—
01
—
3047884
CIGNA
—
01
—
33285
GHP
—
01
—
43190910401
CARE MANAGEMENT RESOURCES
—
01
—
A10272
MERCY HEALTH PLAN
—
01
—
R8D34
LICENSE
MO
Enumeration date
11/13/2006
Last updated
03/07/2023
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