Provider Demographics
NPI:1992798904
Name:MAHON, PATRICK ANDREWS (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ANDREWS
Last Name:MAHON
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 1:87 MCGREGOR ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3731
Mailing Address - Country:US
Mailing Address - Phone:603-627-1887
Mailing Address - Fax:
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3731
Practice Address - Country:US
Practice Address - Phone:603-627-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH8560208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH800001690Medicaid
C65653Medicare UPIN
NHRE169001Medicare PIN