Organization
D MICHAEL MAHAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS MICHAEL MAHAN M.D. (CEO)
(919) 693-7108
Entity
Organization
Contact information
Practice address
120 CHARLES D ROLLINS RD, SUITE 105, HENDERSON, NC 27536-2882
(252) 436-6543
(252) 436-2109
Mailing address
120 CHARLES D ROLLINS RD, SUITE 105, HENDERSON, NC 27536-2882
(252) 436-6543
(252) 436-2109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25053
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012JG
BCBSNC
NC
05
—
89012JG
—
NC
Enumeration date
07/08/2005
Last updated
06/25/2010
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