Individual
PATRICK D MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16901 LAKESIDE HILLS CT, ALEGENT LAKESIDE HOSPITAL DEPT OF RADIOLOGY, OMAHA, NE 68130-2318
(404) 717-8146
Mailing address
PO BOX 4460, OMAHA, NE 68104
(866) 491-5807
(913) 491-0411
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12298
NE
2085R0202X
Diagnostic Radiology Physician
18707
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00093
BCBS
NE
01
—
13705
MIDLANDS
—
01
—
1600520
UHC SHARE ALLIANCE
—
01
—
1601606
UHC SHARE ALLIANCE
—
01
—
17831
BCBS
IA
05
—
2973305
—
IA
05
—
5973305
—
IA
05
—
6973305
—
IA
05
—
7973305
—
IA
05
—
8973305
—
IA
01
—
BM6826513
IA CONTROLLED SUBSTANCE
—
Enumeration date
06/20/2006
Last updated
03/07/2023
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