Individual
KEVIN CHRISTOPHER MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 OLEAN ST, SUITE 220, EAST AURORA, NY 14052-2540
(716) 805-1072
(716) 805-1073
Mailing address
112 OLEAN ST, SUITE 220, EAST AURORA, NY 14052-2540
(716) 805-1072
(716) 805-1073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
203121
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010198703
UNIVERA
NY
01
—
000524278003
BC/BS
NY
01
—
0108198
IHA
NY
05
—
01816673
—
NY
01
—
040426002690
FIDELIS
NY
01
—
080192394
RAILROAD MEDICARE
NY
01
—
148853BF
PREFERRED CARE
NY
01
—
203121
LICENSE
NY
01
—
CK7008
RAILROAD MEDICARE
NY
Enumeration date
02/15/2006
Last updated
07/23/2008
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