Individual
ELIZABETH A MAHANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1312
(508) 368-3190
(508) 368-3193
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605-2038
(508) 368-3190
(508) 368-3193
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
226477
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013994755
UNITED HEALTH CARE
MA
05
—
110041617A
—
MA
01
—
3589507
CIGNA HEALTH PLAN
MA
01
—
494359
TUFTS HEALTH PLAN
MA
01
—
7480522
AETNA
MA
01
—
90832
FALLON COMMUNITY HEALTH
—
01
—
A39481
MEDICARE
MA
01
—
AA44138
HARVARD PILGRIM
MA
01
—
J29570
BLUE CROSS BLUE SHIELD OF MA
MA
Enumeration date
12/23/2005
Last updated
12/29/2017
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