Individual
DR. VICKI MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 FRANCIS ST, #2A, BOSTON, MA 02215-5501
(617) 632-8383
Mailing address
110 FRANCIS ST, #2A, BOSTON, MA 02215-5501
(716) 208-1574
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
157580
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
157580
MA
Other
Enumeration date
07/09/2006
Last updated
03/30/2011
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