MEDICARE: DR. JAMES MEHEGAN PH.D.

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	103TC0700X	Clinical Psychologist	4223	MA

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	:	1801879101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MEHEGAN PH.D.

Provider Business Mailing Address
First Line	:	1 STANDISH RD
Second Line	:
City	:	DUXBURY
State	:	MA
Zip	:	02332-5104
Country	:	US
Telephone Number	:	781-934-9861
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 ALDRIN RD
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4804
Country	:	US
Telephone Number	:	508-747-0665
Fax Number	:

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	07/07/2010

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