Individual
JUSTIN WILSON MCMAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2430 EMERALD PL STE 201, GREENVILLE, NC 27834-5743
(240) 422-4453
Mailing address
2430 EMERALD PL STE 201, GREENVILLE, NC 27834-5743
(864) 828-3692
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
254500
SC
163WC0200X
Critical Care Medicine Registered Nurse
254500
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
008244
NC
Other
Enumeration date
01/08/2024
Last updated
05/05/2026
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