Individual
KEVIN D MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
546 S BROAD ST, MERIDEN, CT 06450-6600
(203) 235-2511
(203) 639-0809
Mailing address
546 S BROAD ST, MERIDEN, CT 06450-6600
(203) 235-2511
(203) 639-0809
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
031598
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001315987
—
CT
01
—
010031598CT02
ANTHEM
CT
01
—
031598
CONNECTICARE
CT
01
—
0R0104
HEALTH NET
CT
01
—
180014360
RAILROAD MEDICARE
CT
01
—
NHS428
OXFORD
CT
Enumeration date
07/29/2005
Last updated
10/26/2007
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