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General NPI Number Information
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NPI Number | 1780656116
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Entity Type | Individual
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Provider Name | JULIA DAWN MAHANEY D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 608 16TH AVE N STE G
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-3537
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Country | US
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Telephone | 210-845-5529
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Fax | 480-546-3211
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Provider Business Mailing Address
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Address Line | 608 16TH AVE N STE G
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-3537
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Country | US
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Telephone | 210-845-5529
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Fax | 480-546-3211
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 300178
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 300178
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 92674
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License Number State | SC
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