Provider Demographics
NPI:1891728705
Name:MCGAHEY, ROBERT PAUL (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:MCGAHEY
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 1:20225 E 9 MILE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1775
Mailing Address - Country:US
Mailing Address - Phone:586-772-1090
Mailing Address - Fax:586-772-4366
Practice Address - Street 1:20225 E 9 MILE RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1775
Practice Address - Country:US
Practice Address - Phone:586-772-1090
Practice Address - Fax:586-772-4366
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010824532080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E011720OtherBCBS GROUP NUMBER
MI0E011720OtherBCBS GROUP NUMBER
I56711Medicare UPIN