Healthcare Provider Details

I. General information

NPI: 1760421762
Provider Name (Legal Business Name): DAVID F MCMAHON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 POWERS ST
BEVERLY MA
01915-2748
US

IV. Provider business mailing address

75 LINDALL STREET CENTER FOR HEALTHY AGING
DANVERS MA
01923-2121
US

V. Phone/Fax

Practice location:
  • Phone: 978-977-3000
  • Fax:
Mailing address:
  • Phone: 978-646-7070
  • Fax: 978-750-6988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number82064
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: