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Individual

CHRISTEN M MAHONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AA

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
10000-00231
NC
367H00000X
Anesthesiologist Assistant
Primary
67.000185
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043446040
TRICARE - NORTH REGION
NC
05
8000500
NC
01
P00742945
RAILROAD MEDICARE
NC
01
P01013330
MEDICARE RAILROAD
OH
Enumeration date
06/04/2009
Last updated
06/04/2013
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