Healthcare Provider Details

I. General information

NPI: 1841222007
Provider Name (Legal Business Name): WILLIAM GLENN MCGUIRT CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 STATE RD
LANCASTER PA
17601-1812
US

IV. Provider business mailing address

1970 ROANOKE BLVD
SALEM VA
24153-6404
US

V. Phone/Fax

Practice location:
  • Phone: 223-287-9000
  • Fax:
Mailing address:
  • Phone: 540-982-2463
  • Fax: 540-725-6956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN769232
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024157684
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: