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General NPI Number Information
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NPI Number | 1578386272
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Entity Type | Individual
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Provider Name | GREGORY T MCMAHAN RN
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Gender | Male
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Dates
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Enumeration Date | 11/02/2024
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Last Update Date | 11/02/2024
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Provider Practice Location Address
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Address Line | 1920 ATHERHOLT RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1120
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Country | US
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Telephone | 434-200-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 11711 ROBIOUS RD
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-2130
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Country | US
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Telephone |
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 0001237445
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License Number State | VA
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