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NPI Code Detail

MEDICARE: DR. JULIA DAWN MAHANEY D.O.

MEDICARE: DR. JULIA DAWN MAHANEY D.O.
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
12084P0800XPsychiatry Physician300178NY
22084A0401XAddiction Medicine (Psychiatry & Neurology) Physician300178NY
32084P0800XPsychiatry Physician92674SC

General Provider Information

NPI Number : 1780656116
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIA DAWN MAHANEY D.O.
Provider Business Mailing Address
First Line : 608 16TH AVE N STE G
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-3537
Country : US
Telephone Number : 210-845-5529
Fax Number : 480-546-3211
Provider Business Practice Location Address
First Line : 608 16TH AVE N STE G
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-3537
Country : US
Telephone Number : 210-845-5529
Fax Number : 480-546-3211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 05/01/2025

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