MEDICARE: DR. LEONARD EDWARD MCGAHA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	1337	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174666283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD EDWARD MCGAHA DDS

Provider Business Mailing Address
First Line	:	1514 N FANT ST
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621-4708
Country	:	US
Telephone Number	:	864-226-8559
Fax Number	:	864-226-8853

Provider Business Practice Location Address
First Line	:	1514 N FANT ST
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621-4708
Country	:	US
Telephone Number	:	864-226-8559
Fax Number	:	864-226-8853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	01/03/2008

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