Individual
TIMOTHY MAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-1000
Mailing address
5157 NAVAJO TRL, PINCKNEY, MI 48169-9397
(517) 862-2933
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301099350
MI
207P00000X
Emergency Medicine Physician
MD.207280
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2188763
—
LA
Enumeration date
07/01/2011
Last updated
02/16/2016
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