Individual
NICHOLAS ROBERT MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-1112
(410) 614-9987
Mailing address
PO BOX 64481, BALTIMORE, MD 21264-4481
(410) 955-1112
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D70837
MD
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
D70837
MD
208600000X
Surgery Physician
MT188147
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036177100
—
MD
Enumeration date
01/12/2007
Last updated
04/29/2016
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