Individual
DR. MICHAEL JOSEPH MCGAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2620 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4205
(308) 398-5560
Mailing address
2717 LAKEWOOD DR, GRAND ISLAND, NE 68801-7271
(308) 381-6656
(308) 381-6680
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0424377
KS
207P00000X
Emergency Medicine Physician
Primary
17445
NE
207Q00000X
Family Medicine Physician
047443
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03470
NE BLUE CROSS BLUE SHIELD
NE
01
—
1235116963
BLUE SHIELD
KS
05
—
1235116963
—
NE
05
—
200579960B
—
KS
05
—
20579960D
—
KS
05
—
47037877912
—
NE
Enumeration date
12/23/2005
Last updated
07/29/2010
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