Individual
MR. MICHAEL JAMES MAHONEY
Active
Individual
MR. MICHAEL JAMES MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2067
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110204
—
MN
05
—
45-00200
—
MN
05
—
45-80212
—
MN
01
—
55030CL
BLUE CROSS& BLUE SHIELD
MN
05
—
82-81124
—
MN
Enumeration date
02/26/2007
Last updated
07/09/2007
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