Individual
REIANA JO MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
551 VETERANS UNITED DR, COLUMBIA, MO 65201-4236
(573) 884-7733
(573) 882-6228
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2022040574
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200071706
—
MO
Enumeration date
06/24/2019
Last updated
11/15/2022
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