Provider Demographics
NPI:1326033325
Name:MAHAN, KIERAN THOMAS (DPM)
Entity type:Individual
Prefix:DR
First Name:KIERAN
Middle Name:THOMAS
Last Name:MAHAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:TEMPLE UNIVERSITY FOOT AND ANKLE INSTITUTE
Mailing Address - Street 2:PO BOX 827282
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0001
Mailing Address - Country:US
Mailing Address - Phone:215-238-6600
Mailing Address - Fax:215-629-0716
Practice Address - Street 1:TEMPLE UNIVERSITY FOOT AND ANKLE INSTITUTE
Practice Address - Street 2:8TH AT RACE STREET
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19117-2496
Practice Address - Country:US
Practice Address - Phone:215-238-6600
Practice Address - Fax:215-629-4905
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC002615L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA096026OtherBLUE SHIELD OF PA
PAP692463OtherOXFORD
PA231365971071OtherTRI-CARE
PAJ96026OtherINTER-CITY
PA0009118720005Medicaid
PA31790OtherKEYSTONE MERCY
PA9259OtherELDER HEALTH / BRAVO
PA3Y2088OtherHEALTH NET
PA911872Medicaid
PA9991253OtherCIGNA
PA0060594000OtherKEYSTONE HEALTH PLAN HMO
NJ190608OtherNJ MEDICAL ASSISTANCE
PA2179196OtherAETNA
PA28824OtherHEALTH PARTNERS
PA231365971OtherHUMANA
PA435719OtherHEALTH AMERICA HEALTH ASSURANCE
PA480029986OtherRAILROAD MEDICARE
PA91187203OtherHMA
PA231365971OtherUNITED HEALTH CARE
PA96026OtherKEYSTONE HEALTH PLAN PPO
PA2179196OtherAETNA
T28498Medicare UPIN