Charles Keith Mahan, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

2600 Tarawa CT
Norfolk, VA 23521-3235

Phone

(757) 462-5544

NPI assigned

Aug 29, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1659529964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TARAWA CT",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235213235",
            "telephone_number": "757-462-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TARAWA CT",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235213235",
            "telephone_number": "757-462-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "CHARLES",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton C. Maguire, L.P.C. L.M.F.T.
• Katelyn Rose Maguire, DO
• Linda J. Maguire, LCSW
• Richard Fetherston Maguire III, MD
• Samuel M. Mahaffey, M.D.
• Angela D Maher, NP
• Sarah Burlock Mahmoud, OD
• Ellen Mahon, MD
• Diane Maia, MD
• Julia A Mains, PTA

• Independent Duty Corpsman in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Independent Duty Corpsman in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.