License NumberC0004638 Tara Janen Mahan
License TypePhysician Assistant
License StatusActive    
License Issued10/31/2011  License Expiration6/30/2025

Licensure Pathway:   Traditional
Special License Category:   N/A
Primary Practice Setting
N/A
Public Address
No Public Address Available
 Medical Assistance

Accept Medicaid? N/A

 Maryland Hospital Privilege Information (as reported by licensee)

Licensee has not reported Maryland Hospital Privilege information for the profile site.
 Medical Licenses Held in Other States (as reported by licensee)

Licensee has not reported Medical Licenses Held in Other States information for the profile site.


 Active Supervisee - Delegation Agreement For Core Duties

D0077463  Anup Amit Vora   Status: Approved |  Approved Date: 12/04/2017 | Agreement No: 17094
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0051808  Thomas Keith Huisman   Status: Approved |  Approved Date: 11/25/2019 | Agreement No: 19765
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0047386  Richard Levin   Status: Approved |  Approved Date: 02/24/2022 | Agreement No: 30385
Prescribe CDS: Yes | Non-CDS: No | Medical Devices: No
Dispense CDS: No | Dispense NCDS: No
 Known Disciplinary Actions by any state medical board (within the past 10 years)

In Maryland:

No Known Disciplinary Actions by the Maryland Board of Physicians have been reported.

Other States:

No Known Disciplinary Actions by any other state medical board have been reported.
 Download all Maryland Disciplinary Actions

All Orders are downloaded in .pdf format.
None.
 Pending Charges  Please Read Disclaimer

All Charges are downloaded in .pdf format.
None.
 Other Public Actions in the Practice of the Profession or Administrative Fines (including Maryland)  Please Read Description

No reported Other Public Actions in the Practice of the Profession or Administrative Fines (incl. Maryland) for this licensee.

Maryland Board of Physicians 4201 Patterson Avenue Baltimore, MD 21215
410.764.4777 | Toll Free 800.492.6836