Individual
DANIELLE L MAHAFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
336 DEERFIELD RD, BOONE, NC 28607-5008
(828) 262-4209
(828) 262-4103
Mailing address
336 DEERFIELD RD, BOONE, NC 28607-5008
(828) 262-4209
(828) 262-4103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
97-01472
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
97-01472
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1212660004
DME
—
05
—
8912533
—
NC
01
—
CB8658
RR GROUP
—
01
—
P00349915
RR MEDICARE
—
Enumeration date
07/15/2006
Last updated
04/16/2018
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