Provider Demographics
NPI:1518945237
Name:MCMAHON, EUGENE J (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:J
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4204
Mailing Address - Country:US
Mailing Address - Phone:561-712-7335
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:11020 W PLANK CT
Practice Address - Street 2:SUITE 100
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3279
Practice Address - Country:US
Practice Address - Phone:414-476-8122
Practice Address - Fax:414-475-2975
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI35412207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83456Medicare UPIN