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General NPI Number Information
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NPI Number | 1134791445
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Entity Type | Individual
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Provider Name | SHANE M MCMAHON DO
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Gender | Male
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL UNIT #15281 BLDG. 3031, CAMP HUMPHREYS
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City | APO
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State | AP
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Zip | 96271
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Country | US
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Telephone | 727-455-4207
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 444 BOX 2288
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City | APO
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State | AP
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Zip | 96297-0023
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Country | US
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Telephone | 727-455-4207
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS022933
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License Number State | PA
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