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Individual

CATHERINE MAHON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 985-6920

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110006598
VA
363A00000X
Physician Assistant
Primary
13770
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000000000
N/A
Enumeration date
02/08/2019
Last updated
08/13/2021
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