Provider Demographics
NPI:1578213443
Name:MAGUIRE, AMELIA BEZERRA (DPM)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:BEZERRA
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:MRS
Other - First Name:AMELIA
Other - Middle Name:CAIADO
Other - Last Name:BEZERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1121 N ROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3470
Mailing Address - Country:US
Mailing Address - Phone:252-338-2111
Mailing Address - Fax:252-338-2113
Practice Address - Street 1:1121 N ROAD ST STE B
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3470
Practice Address - Country:US
Practice Address - Phone:252-338-2111
Practice Address - Fax:252-338-2113
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC858213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine