Provider Demographics
NPI:1285950527
Name:MAHONEY, ADAM JAMES (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:JAMES
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 W STATE ST
Mailing Address - Street 2:STE 510
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1515
Mailing Address - Country:US
Mailing Address - Phone:614-464-0788
Mailing Address - Fax:614-464-0295
Practice Address - Street 1:745 W STATE ST
Practice Address - Street 2:STE 510
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1515
Practice Address - Country:US
Practice Address - Phone:614-464-0788
Practice Address - Fax:614-464-0295
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-120375207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease