MEDICARE: DENNIS MICHAEL MAHAN M.D.

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
1	208D00000X	General Practice Physician	25053	NC
2	207Q00000X	Family Medicine Physician	25053	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080185950	OTHER		RAILROAD MEDICARE
4	080181994	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	53753	OTHER	NC	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477550473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS MICHAEL MAHAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 986
Second Line	:
City	:	OXFORD
State	:	NC
Zip	:	27565-0986
Country	:	US
Telephone Number	:	919-690-3487
Fax Number	:	919-690-3246

Provider Business Practice Location Address
First Line	:	1032 COLLEGE ST
Second Line	:
City	:	OXFORD
State	:	NC
Zip	:	27565-2507
Country	:	US
Telephone Number	:	919-693-6541
Fax Number	:	919-693-7396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/21/2022

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Directions to “ DENNIS MICHAEL MAHAN M.D.” Practice Location

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