Provider Demographics
NPI:1528087996
Name:MCMAHON, DANIEL ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2269 SOUREK TRL
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-4755
Mailing Address - Country:US
Mailing Address - Phone:330-835-4853
Mailing Address - Fax:
Practice Address - Street 1:300 LOCUST ST
Practice Address - Street 2:SUITE 260
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1821
Practice Address - Country:US
Practice Address - Phone:330-376-3332
Practice Address - Fax:330-376-2980
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059905208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0171997Medicaid
OHF67353Medicare UPIN
OH0171997Medicaid