Healthcare Provider Details

I. General information

NPI: 1134194871
Provider Name (Legal Business Name): PATRICK J MCMAHON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 JANE ST ROESCHE TAYLOR BLDG
PITTSBURGH PA
15203-2065
US

IV. Provider business mailing address

2100 JANE ST ROESCHE TAYLOR BLDG
PITTSBURGH PA
15203-2065
US

V. Phone/Fax

Practice location:
  • Phone: 412-431-7342
  • Fax:
Mailing address:
  • Phone: 412-431-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD042445L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: