Healthcare Provider Details

I. General information

NPI: 1902363971
Provider Name (Legal Business Name): RICHARD FETHERSTON MAGUIRE III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 GILBERT ST
NORFOLK VA
23511-2941
US

IV. Provider business mailing address

4904 ACLARE CT
VIRGINIA BEACH VA
23462-3532
US

V. Phone/Fax

Practice location:
  • Phone: 757-322-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2865X1600X
TaxonomyOperational (Transportable) Military General Acute Care Hospital
License Number0101270242
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101270242
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: