Individual
BRUCE W MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 GOODMAN STREET, CINCINNATI, OH 45219
(513) 584-2146
(513) 584-0431
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3107
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.09-0438
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2796621
—
OH
Enumeration date
06/07/2007
Last updated
02/20/2018
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