MEDICARE: NATHAN J MCGWIN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0110-004283	VA

General Provider Information

NPI Number	:	1154760056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN J MCGWIN PA-C

Provider Business Mailing Address
First Line	:	6035 BURKE CENTRE PKWY STE 120
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-3750
Country	:	US
Telephone Number	:	608-697-8447
Fax Number	:

Provider Business Practice Location Address
First Line	:	6035 BURKE CENTRE PKWY STE 120
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-3750
Country	:	US
Telephone Number	:	703-425-6010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	04/17/2026

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