Mahoney, Timothy J

Mahoney, Timothy J is an individual health care provider with primary practice located at 1707 Gold Dr S Ste 101 , Fargo ND 58103-6413. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Mahoney, Timothy J can be contacted via phone (701) 280-2033.

Contact Information

Primary practice address
1707 Gold Dr S Ste 101 Fargo ND 58103-6413
Phone: (701) 280-2033
Fax: (701) 232-5578
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3622 North Dakota
Allopathic & Osteopathic Physicians / Surgery 208600000X 24007 Minnesota
Allopathic & Osteopathic Physicians / General Practice 208D00000X 3622 North Dakota
Allopathic & Osteopathic Physicians / Surgery 208600000X 3622 North Dakota

Profile Details

NPI number 1689608192
LBN Legal business name Mahoney, Timothy J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Jan 12th, 2024 - about 2 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 1689608192 NPPES
North Dakota Other 120231 UCARE #
North Dakota Other 1700559 UCARE #
North Dakota Other 20698 UCARE #
North Dakota Other 2164 UCARE #
North Dakota Other 844548 UCARE #
North Dakota MEDICAID 13390 UCARE #
North Dakota Other ND20017469 UCARE #
North Dakota Other 1700509 UCARE #
North Dakota Other 6508 UCARE #
North Dakota Other DA9011008232 UCARE #

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