Provider Demographics
NPI:1114949823
Name:MCMAHON, RICHARD C (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 MAIN ST STE 203B
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1187
Mailing Address - Country:US
Mailing Address - Phone:508-881-3029
Mailing Address - Fax:508-881-1752
Practice Address - Street 1:101 COOLIDGE ST
Practice Address - Street 2:DOWNSTAIRS
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-1354
Practice Address - Country:US
Practice Address - Phone:978-562-0757
Practice Address - Fax:978-562-9299
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6177093Medicaid
MA6177093Medicaid
J02881Medicare ID - Type Unspecified