Individual
JOHN M MAHOWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25694
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736805400
—
MN
Enumeration date
08/12/2005
Last updated
10/12/2011
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