Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D0047443 | MD |
Y | 208600000X | Surgeon | D0047443 | MD |
NPI | 1013916055 |
---|---|
Provider Name | Dr. William Michael Mahaffey |
First Address | Leonardtown, MD 20650-3801 |
Second Address | Leonardtown, MD 20650-3801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 23/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
377741300 | (05) | MD |
G03393 | (02) | MD |