Individual
KATHLEEN MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
3055 LEEWARD WAY, LITTLE CANADA, MN 55109-1066
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
62879
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2013
Last updated
02/18/2019
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