Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 14871 | AL |
NPI | 1073558458 |
---|---|
Provider Name | William Stephen Mcmahon |
First Address | Birmingham, AL 35255-5823 |
Second Address | Birmingham, AL 35233-1802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 04/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13264 | HEALTHSPRING (01) | AL |
E23348 | (02) | |
E23348 | VIVA (01) |