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Individual

PHILIP A MAHONEY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
120 HEYWOOD AVE, SPARTANBURG, SC 29302-1210
(864) 562-5102
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24636
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
246362
SC
01
P01617594
RAILROD MEDICARE
SC
Enumeration date
05/22/2006
Last updated
02/04/2021
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