MEDICARE: JAMES J.O. MAGAURAN M.D.

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	2084P0804X	Child & Adolescent Psychiatry Physician	217227	MA

General Provider Information

NPI Number	:	1447316807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES J.O. MAGAURAN M.D.

Provider Business Mailing Address
First Line	:	76 BEDFORD ST STE 34
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4641
Country	:	US
Telephone Number	:	617-548-8111
Fax Number	:	781-861-8729

Provider Business Practice Location Address
First Line	:	76 BEDFORD ST STE 34
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4641
Country	:	US
Telephone Number	:	617-548-8111
Fax Number	:	781-861-8729

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	03/23/2018

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