Individual
KIAME JACKSON MAHANIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
47 CONGRESS ST, SALEM, MA 01970-7308
(978) 744-8388
Mailing address
47 CONGRESS ST, SALEM, MA 01970-7308
(978) 744-8388
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
219111
MA
Other
Enumeration date
09/26/2005
Last updated
07/20/2012
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