Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 29510 | IA |
NPI | 1033183348 |
---|---|
Provider Name | Paula R Mahone |
First Address | Des Moines, IA 50309-1416 |
Second Address | Des Moines, IA 50309-1416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101188 | (05) | IA |
E93021 | (02) |