Provider Demographics
NPI:1891853420
Name:MCMAHON, WILLIAM LEWIS (MD MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEWIS
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:MD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 WINDING ROSE DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3074
Mailing Address - Country:US
Mailing Address - Phone:678-889-4880
Mailing Address - Fax:678-889-4881
Practice Address - Street 1:4905 WINDING ROSE DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-3074
Practice Address - Country:US
Practice Address - Phone:770-313-2034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA45885207P00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00809322BMedicaid
GA93BDNPVMedicare ID - Type Unspecified
GA00809322BMedicaid