MEDICARE: DR. PHILIP ANDREW MAHAN D.C.

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	111N00000X	Chiropractor	2779	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2024315	OTHER	NC	FITSR HEALTH
2	08453	OTHER	NC	BLUE CROSS/BLUE SHEILD
3	616607	OTHER	NC	AMERICAN CHIROPRACTIC NET
4	6416476001	OTHER	NC	CIGNA PPO
5	2684545	OTHER	NC	AETNA HMO
6	37243	OTHER	NC	PATRNERS
7	7108174	OTHER	NC	AETNA PPO
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720075997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP ANDREW MAHAN D.C.

Provider Business Mailing Address
First Line	:	813 S MAIN ST
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-3150
Country	:	US
Telephone Number	:	336-243-8000
Fax Number	:	336-243-8001

Provider Business Practice Location Address
First Line	:	813 S MAIN ST
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-3150
Country	:	US
Telephone Number	:	336-243-8000
Fax Number	:	336-243-8001

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	09/25/2012

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