Doctor Name: | DENNIS MICHAEL MAHAN |
NPI Number: | 1477550473 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 25053 |
Business Practice Address: | 103 Professional Park A Oxford, NC - 275652566 |
Business Phone Number: | 9196937108 |
Business Fax Number: | 9196939245 |
Mailing Address: | 103 Professional Park A, OXFORD |
State: | NC |
Postal Code: | 275652566 |
Phone Number: | 9196937108 |
Fax Number: | 9196939245 |
NPI Enumeration Date: | 07/05/2005 |
NPI Last Update Date: | 10/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25053 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |