Individual
TARA JANEN MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
950 HARRY S TRUMAN DR N STE 500, LARGO, MD 20774-5486
(301) 321-1122
Mailing address
10200 GRAND CENTRAL AVE STE 220, OWINGS MILLS, MD 21117-4366
(410) 581-1600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C04638
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607156012
DEPT OF LABOR
—
01
—
607156014
BLACK LUNG
—
Enumeration date
11/14/2011
Last updated
05/30/2025
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