MEDICARE: RYAN DENNIS MCMAHON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	FM6522127	MN

General Provider Information

NPI Number	:	1992449300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN DENNIS MCMAHON MD

Provider Business Mailing Address
First Line	:	14700 28TH AVE N STE 20
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55447-4876
Country	:	US
Telephone Number	:	763-559-3779
Fax Number	:

Provider Business Practice Location Address
First Line	:	6500 EXCELSIOR BLVD
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-4700
Country	:	US
Telephone Number	:	952-993-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2022
Last Update Date	:	06/03/2026

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