Healthcare Provider Details

I. General information

NPI: 1275503146
Provider Name (Legal Business Name): JAMES ROBERT MCMAHON CFNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL CHERRY POINT PSC BOX 8023
CHERRY POINT NC
28533-0023
US

IV. Provider business mailing address

236 HAILE ST
SUMTER SC
29150-3272
US

V. Phone/Fax

Practice location:
  • Phone: 252-466-0295
  • Fax: 252-466-0159
Mailing address:
  • Phone: 803-720-2212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 999
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: