Provider Demographics
NPI:1730219031
Name:MAHONEY, STEVEN T (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:T
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 MINSTREL WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5274
Mailing Address - Country:US
Mailing Address - Phone:410-290-8100
Mailing Address - Fax:410-290-8101
Practice Address - Street 1:7120 MINSTREL WAY STE 104
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5274
Practice Address - Country:US
Practice Address - Phone:410-290-8100
Practice Address - Fax:410-290-8101
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD801M385FMedicare ID - Type Unspecified