Provider Demographics
NPI:1013904390
Name:MCMAHAN, HOWARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:A
Last Name:MCMAHAN
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 1:550 PEACHTREE ST NE
Mailing Address - Street 2:19TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-215-2000
Mailing Address - Fax:404-215-2001
Practice Address - Street 1:550 PEACHTREE ST NE FL 19
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-215-2000
Practice Address - Fax:404-215-2001
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-01-15
Deactivation Date:2018-05-21
Deactivation Code:
Reactivation Date:2020-01-15
Provider Licenses
StateLicense IDTaxonomies
GA024027207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000250511DMedicaid
GA20BBDRCMedicare PIN
GA000250511DMedicaid