Provider Demographics
NPI:1649205196
Name:MCMAHON, KEVIN F (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:F
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:PO BOX 3478
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14240-3478
Mailing Address - Country:US
Mailing Address - Phone:716-634-8800
Mailing Address - Fax:716-650-9622
Practice Address - Street 1:3112 SHERIDAN DRIVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1904
Practice Address - Country:US
Practice Address - Phone:716-831-9435
Practice Address - Fax:716-831-9475
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202485-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01647158Medicaid
NYC79606Medicare ID - Type Unspecified
NY01647158Medicaid