Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 34077 | NC |
Y | 207RX0202X | Medical Oncology | 34077 | NC |
NPI | 1063429561 |
---|---|
Provider Name | John F Mahoney |
First Address | Charlotte, NC 28260-2120 |
Second Address | Charlotte, NC 28277-3297 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 12/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063429561 | (05) | NC |
53737 | BCBS (01) | NC |
8953737 | (05) | NC |
B47965 | (02) | |
N34077 | (05) | SC |