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General NPI Number Information
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NPI Number | 1780188680
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Entity Type | Individual
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Provider Name | DEVON MAHONEY MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 620 JOHN PAUL JONES CIR
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2111
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Country | US
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Telephone | 579-535-0087
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 RIVER PEARL WAY
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City | CHESAPEAKE
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State | VA
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Zip | 23321-3773
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Country | US
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Telephone | 770-241-2809
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 2019-02437
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 2019-02437
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 2019-02437
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License Number State | NC
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