Healthcare Provider Details

I. General information

NPI: 1649338096
Provider Name (Legal Business Name): JANET LYNN MCGUIRE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET LYNN GRABOFSKI PA-C

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 WILLIAMSPORT PIKE
MARTINSBURG WV
25404-4341
US

IV. Provider business mailing address

11350 MCCORMICK ROAD EXECUTIVE PLAZA 1, SUITE 501
HUNT VALLEY MD
21031
US

V. Phone/Fax

Practice location:
  • Phone: 304-596-2378
  • Fax:
Mailing address:
  • Phone: 410-329-1071
  • Fax: 410-329-1054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9102167
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1523
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: