Provider Demographics
NPI:1235131491
Name:MCMAHON, STEVEN JOHN (M D)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JOHN
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7796
Mailing Address - Country:US
Mailing Address - Phone:919-787-7171
Mailing Address - Fax:919-420-2028
Practice Address - Street 1:3010 ANDERSON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7796
Practice Address - Country:US
Practice Address - Phone:919-787-7171
Practice Address - Fax:919-420-2028
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200700554207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14796OtherBCBSNC
NC2075673Medicare PIN
NC14796OtherBCBSNC