MEDICARE: DR. MEGHAN AILEEN MAHONEY MD

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	390200000X	Student in an Organized Health Care Education/Training Program		CO
2	207V00000X	Obstetrics & Gynecology Physician	1972008084	CO

General Provider Information

NPI Number	:	1972008084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGHAN AILEEN MAHONEY MD

Provider Business Mailing Address
First Line	:	10569 CHAMBERS RD STE 100
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-8950
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10569 CHAMBERS RD STE 100
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-8950
Country	:	US
Telephone Number	:	303-498-1600
Fax Number	:

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

Provider Enumeration Date	:	03/29/2018
Last Update Date	:	08/10/2022

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