Provider Demographics
NPI:1851330856
Name:MCKEOUGH, PAUL G (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:G
Last Name:MCKEOUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:48 MONTVALE AVE
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2425
Mailing Address - Country:US
Mailing Address - Phone:781-279-0655
Mailing Address - Fax:781-279-0409
Practice Address - Street 1:48 MONTVALE AVE
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2425
Practice Address - Country:US
Practice Address - Phone:781-279-0655
Practice Address - Fax:781-279-0409
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA703442085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology