Mahoney, Michael James

Mahoney, Michael James is an sole proprietor health care provider with primary practice located at 215 Park Ave S Suite 101, Saint Cloud MN 56301-3736. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Mahoney, Michael James can be contacted via phone (320) 252-0452.

Contact Information

Primary practice address
215 Park Ave S Suite 101 Saint Cloud MN 56301-3736
Phone: (320) 252-0452
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X 2067 Minnesota

Profile Details

NPI number 1144356973
LBN Legal business name Mahoney, Michael James
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144356973 NPPES
Minnesota MEDICAID 45-80212
Minnesota MEDICAID 45-00200
Minnesota MEDICAID 110204
Minnesota Other 55030CL
Minnesota MEDICAID 82-81124

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