Provider Demographics
NPI:1275503146
Name:MCMAHON, JAMES ROBERT (CFNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROBERT
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 HAILE ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-3272
Mailing Address - Country:US
Mailing Address - Phone:803-720-2212
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL CHERRY POINT
Practice Address - Street 2:PSC BOX 8023
Practice Address - City:CHERRY POINT
Practice Address - State:NC
Practice Address - Zip Code:28533-0023
Practice Address - Country:US
Practice Address - Phone:252-466-0295
Practice Address - Fax:252-466-0159
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily