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Individual

MARY MAHONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
234 GOODMAN ST, ML 0772, CINCINNATI, OH 45267-1000
(513) 584-5335
(584) 584-3663
Mailing address
3200 BURNET AVE, CINCINNATI, OH 45229-3019
(513) 585-5501
(513) 584-3663

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-05-4612
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000013495
ANTHEM
OH
05
0701226
OH
01
1621098
UHC
OH
05
200129330A
IL
01
645406
AETNA
OH
05
64860372
KY
Enumeration date
05/24/2006
Last updated
10/18/2013
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