Individual
MARY MAHONEY
Active
Individual
MARY MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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
Update your record
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