Provider Demographics
NPI:1881670370
Name:MCGAHEY, CHARLES MARVIN JR (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:MARVIN
Last Name:MCGAHEY
Suffix:JR
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 1:2908 MALL DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1534
Mailing Address - Country:US
Mailing Address - Phone:256-767-2702
Mailing Address - Fax:256-760-1870
Practice Address - Street 1:2908 MALL DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1534
Practice Address - Country:US
Practice Address - Phone:256-767-2702
Practice Address - Fax:256-760-1870
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12014207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51014729OtherBLUECROSSBLUESHIELD
ALE368OtherMEDICARE
ALE368OtherMEDICARE