1326033325 NPI number — DR. KIERAN THOMAS MAHAN DPM

Table of content: AARON GOLDSBERRY (NPI 1073269767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326033325 NPI number — DR. KIERAN THOMAS MAHAN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAHAN
Provider First Name:
KIERAN
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326033325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
TEMPLE UNIVERSITY FOOT AND ANKLE INSTITUTE
Provider Second Line Business Mailing Address:
PO BOX 827282
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19182-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-238-6600
Provider Business Mailing Address Fax Number:
215-629-0716

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TEMPLE UNIVERSITY FOOT AND ANKLE INSTITUTE
Provider Second Line Business Practice Location Address:
8TH AT RACE STREET
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19117-2496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-238-6600
Provider Business Practice Location Address Fax Number:
215-629-4905
Provider Enumeration Date:
09/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  SC002615L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MA096026 . This is a "BLUE SHIELD OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P692463 . This is a "OXFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 231365971071 . This is a "TRI-CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: J96026 . This is a "INTER-CITY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009118720005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 31790 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 9259 . This is a "ELDER HEALTH / BRAVO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3Y2088 . This is a "HEALTH NET" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 911872 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9991253 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0060594000 . This is a "KEYSTONE HEALTH PLAN HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 190608 . This is a "NJ MEDICAL ASSISTANCE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2179196 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 28824 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 231365971 . This is a "HUMANA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 435719 . This is a "HEALTH AMERICA HEALTH ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 480029986 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 91187203 . This is a "HMA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 231365971 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 96026 . This is a "KEYSTONE HEALTH PLAN PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com