Provider Demographics
NPI:1609815125
Name:MAHAN, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:MAHAN
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 1:1000 FLORAL VALE BLVD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5569
Mailing Address - Country:US
Mailing Address - Phone:215-785-9500
Mailing Address - Fax:
Practice Address - Street 1:1000 FLORAL VALE BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5569
Practice Address - Country:US
Practice Address - Phone:215-785-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021725E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006570890003Medicaid
290010339OtherRAILROAD MEDICARE
C29352Medicare UPIN
084787LIHMedicare ID - Type Unspecified
290010339OtherRAILROAD MEDICARE