Basic Information
Provider Information
NPI: 1548396252
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGAHEE
FirstName: SHUNDA
MiddleName: MONIQUE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 780 ALBANY ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021182524
CountryCode: US
TelephoneNumber: 8576541000
FaxNumber: 8576541100
Practice Location
Address1: 780 ALBANY ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021182524
CountryCode: US
TelephoneNumber: 8576541000
FaxNumber: 8576541100
Other Information
ProviderEnumerationDate: 02/26/2007
LastUpdateDate: 03/08/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XL-225505MAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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