Individual provider Active NPI

William Michael Mahaffey, M.D.

  • Surgery Physician
  • Leonardtown, MD
National Provider Identifier
1013916055
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0047443 Issued in MD
Practice address
25480 Point Lookout Rd
Leonardtown, MD 20650-3801
Phone
(301) 997-0909
Fax
(301) 997-0919
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D0047443 MD Primary

Addresses

Primary practice location

25480 Point Lookout Rd
Leonardtown, MD 20650-3801

Mailing address

25480 Point Lookout Rd
Leonardtown, MD 20650-3801
Phone (301) 997-0909

Other identifiers 1

IdentifierTypeStateIssuer
377741300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0047443MDMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1013916055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25480 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503801",
            "telephone_number": "301-997-0909",
            "fax_number": "301-997-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25480 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503801",
            "telephone_number": "301-997-0909",
            "fax_number": "301-997-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAFFEY",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0047443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377741300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.