Healthcare Provider Details

I. General information

NPI: 1457310575
Provider Name (Legal Business Name): JOHN P MCGUIRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 STATE ROAD WATUPPA BUILDING SUITE 203
NORTH DARTMOUTH MA
02747-3300
US

IV. Provider business mailing address

49 STATE ROAD WATUPPA BUILDING SUITE 203
NORTH DARTMOUTH MA
02747-3300
US

V. Phone/Fax

Practice location:
  • Phone: 508-994-0120
  • Fax: 508-996-9636
Mailing address:
  • Phone: 508-994-0120
  • Fax: 508-996-9636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number159246
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: