Provider Demographics
NPI:1871561217
Name:MCGUIRE, PATRICIA M (MD FAAP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MD FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 WESTDALE DR SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-6326
Mailing Address - Country:US
Mailing Address - Phone:319-365-1006
Mailing Address - Fax:319-365-1038
Practice Address - Street 1:2215 WESTDALE DR SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-6326
Practice Address - Country:US
Practice Address - Phone:319-365-1006
Practice Address - Fax:319-365-1038
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA284262080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2078121Medicaid
IAI16321Medicare PIN
IA2078121Medicaid