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General NPI Number Information
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NPI Number | 1386669299
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Entity Type | Organization
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Legal Business Name | PEDIATRIC & ADOLESCENT UROLOGY, INC.
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 215 W BOWERY ST SUITE 3500
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City | AKRON
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State | OH
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Zip | 44308-1069
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Country | US
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Telephone | 330-376-3332
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Fax | 330-376-2980
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Provider Business Mailing Address
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Address Line | 215 W BOWERY ST SUITE 3500
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City | AKRON
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State | OH
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Zip | 44308-1069
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Country | US
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Telephone | 330-376-3332
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Fax | 330-376-2980
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DANIEL R MCMAHON
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Credential | M.D.
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Telephone | 330-376-3332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | OH
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