Mahon, Gerald

Mahon, Gerald is an individual health care provider with primary practice located at 1201 S Grand Blvd , Saint Louis MO 63104-1016. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Mahon, Gerald can be contacted via phone (314) 977-8462.

Contact Information

Primary practice address
1201 S Grand Blvd Saint Louis MO 63104-1016
Phone: (314) 977-8462
Fax: (314) 977-3370
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X R4H74 Missouri

Profile Details

NPI number 1154302289
LBN Legal business name Mahon, Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Mar 12th, 2021 - about 5 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 1154302289 NPPES
Missouri Other 000000011339 ESSENCE
Missouri Other 138654 ESSENCE
Missouri Other 0400402 ESSENCE
Missouri Other 39965 ESSENCE
Missouri Other 4136351 ESSENCE
Missouri Other A12432 ESSENCE
Missouri Other 17644 ESSENCE

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