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General NPI Number Information
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NPI Number | 1124610928
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Entity Type | Individual
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Provider Name | PATRICK MICHAEL MAHON ACNPC-AG, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/03/2021
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 12 CHATSWORTH AVE
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City | GLYNDON
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State | MD
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Zip | 21071-4224
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Country | US
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Telephone | 609-456-8861
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Fax | 410-297-0728
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Provider Business Mailing Address
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Address Line | PO BOX 103
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City | GLYNDON
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State | MD
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Zip | 21071-0103
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Country | US
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Telephone | 609-456-8861
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | R224708
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R224708
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R224708
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License Number State | MD
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