Provider Demographics
NPI:1043356066
Name:MCGUIRE, MICHAEL ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:MCGUIRE
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 1:770 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2547
Mailing Address - Country:US
Mailing Address - Phone:610-269-1372
Mailing Address - Fax:610-269-6951
Practice Address - Street 1:770 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2547
Practice Address - Country:US
Practice Address - Phone:610-269-1372
Practice Address - Fax:610-269-6951
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056813L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6119780OtherCIGNA HMO
PA0216297000OtherIBC HMO
PA0816374OtherAETNA HMO
PA0216297000OtherIBC
PA535251OtherHIGHMARK BCBS
PA0016864600001Medicaid
PA56820OtherCOVENTRY HMO
PAP029888OtherTRICARE
PA268224OtherMAMSI HMO
PA0016864600001Medicaid
PA0216297000OtherIBC HMO