Healthcare Provider Details

I. General information

NPI: 1508912049
Provider Name (Legal Business Name): TERENCE ALOYSIUS MCGUIRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2935 DAVIDSONVILLE RD
DAVIDSONVILLE MD
21035-0069
US

IV. Provider business mailing address

PO B 69 2935 DAVIDSONVILLE RD
DAVIDSONVILLE MD
21035-0069
US

V. Phone/Fax

Practice location:
  • Phone: 410-798-9819
  • Fax: 410-798-9819
Mailing address:
  • Phone: 410-798-9819
  • Fax: 410-798-9819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberD0009196
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: