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NPI Code Detail

MEDICARE: DAVID MAHONEY

MEDICARE: DAVID MAHONEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist04980MD

General Provider Information

NPI Number : 1295090421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MAHONEY
Provider Business Mailing Address
First Line : 20400 OBSERVATION DR STE 103
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-4086
Country : US
Telephone Number : 301-873-7214
Fax Number :
Provider Business Practice Location Address
First Line : 20400 OBSERVATION DR STE 103
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-4086
Country : US
Telephone Number : 301-873-7214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2012
Last Update Date : 07/13/2012

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Directions to “ DAVID MAHONEY ” Practice Location

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