Provider Demographics
NPI:1215296785
Name:O'MAHONY MCEVOY, KATHERINE (MB BCH)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:O'MAHONY MCEVOY
Suffix:
Gender:F
Credentials:MB BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WINNIPEG
Mailing Address - Street 2:BALLEA ROAD
Mailing Address - City:CARRIGALINE
Mailing Address - State:CORK
Mailing Address - Zip Code:00000
Mailing Address - Country:IE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:MEYER 1-104
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-6114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry