Healthcare Provider Details

I. General information

NPI: 1144905662
Provider Name (Legal Business Name): RACHEL MARIE MAHON DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31500 TELEGRAPH RD STE 235
BINGHAM FARMS MI
48025-4315
US

IV. Provider business mailing address

31500 TELEGRAPH RD STE 235
BINGHAM FARMS MI
48025-4315
US

V. Phone/Fax

Practice location:
  • Phone: 248-646-6822
  • Fax:
Mailing address:
  • Phone: 248-646-6882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901400615
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: