Provider Demographics
NPI:1275640518
Name:MCMAHON, CLAIRE KATHLEEN (MD, FAAP, FACC)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:KATHLEEN
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:MD, FAAP, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10111 S CENTENNIAL PKWY STE 510
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4169
Mailing Address - Country:US
Mailing Address - Phone:435-216-3591
Mailing Address - Fax:435-237-0242
Practice Address - Street 1:5495 S 500 E STE 100
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-7422
Practice Address - Country:US
Practice Address - Phone:435-216-3591
Practice Address - Fax:435-237-0242
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA072604002080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8633801Medicaid
NJH48988Medicare UPIN
NJ051286MX4Medicare ID - Type Unspecified