Healthcare Provider Details

I. General information

NPI: 1912820747
Provider Name (Legal Business Name): GLYNIS MCGOWAN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR # 10194
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR # 10194
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 617-299-1456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: GLYNIS MCGOWAN
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 617-299-1456