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Individual

DR. RUTH ELLEN O'MAHONY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
897 W MAIN ST, SUITE 700, DOVER FOXCROFT, ME 04426-1029
(207) 564-4466
Mailing address
897 W MAIN ST, SUITE 700, DOVER FOXCROFT, ME 04426-1029
(207) 564-4466

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
018008
ME
208600000X
Surgery Physician
13223
NH
208600000X
Surgery Physician
ME93215
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000587801
MEDICARE PTAN
ME
01
P00654554
RAILROAD MEDICARE
ME
Enumeration date
07/04/2006
Last updated
01/29/2009
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