Provider Demographics
NPI:1588692818
Name:MCMAHON, MATTHEW J (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:202 10TH ST SE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2404
Mailing Address - Country:US
Mailing Address - Phone:319-364-7101
Mailing Address - Fax:319-363-1993
Practice Address - Street 1:202 10TH ST SE
Practice Address - Street 2:SUITE 225
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2404
Practice Address - Country:US
Practice Address - Phone:319-364-7101
Practice Address - Fax:319-363-1993
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA01684207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1588692818Medicaid
IAP00818162OtherRR MEDICARE
IAP00818162OtherRR MEDICARE
IAIB1600008Medicare PIN
IAIB1599008Medicare PIN