Provider Demographics
NPI:1710064191
Name:MAHON, BARBARA E (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:E
Last Name:MAHON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W BENSON ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-4311
Mailing Address - Country:US
Mailing Address - Phone:617-791-0928
Mailing Address - Fax:
Practice Address - Street 1:221 W BENSON ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4311
Practice Address - Country:US
Practice Address - Phone:617-791-0928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA39628208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA21852OtherHARVARD PILGRIM HEALTHCAR
MAJ25838OtherBLUE CROSS BLUE SHIELD
MAF52841Medicare UPIN
MAA35103Medicare ID - Type Unspecified