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General NPI Number Information
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NPI Number | 1326196080
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Entity Type | Organization
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Legal Business Name | RAYMOND G. MAGAURAN, M.D., P.C.
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5 BAY STATE CT
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City | BREWSTER
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State | MA
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Zip | 02631-2120
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Country | US
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Telephone | 508-255-9421
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Fax | 508-255-6702
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Provider Business Mailing Address
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Address Line | 5 BAY STATE CT
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City | BREWSTER
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State | MA
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Zip | 02631-2120
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Country | US
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Telephone | 508-255-9421
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Fax | 508-255-6702
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Authorized Official
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Title or Position | OWNER
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Name | RAYMOND G MAGAURAN
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Credential | M.D.
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Telephone | 508-255-9421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 78030
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License Number State | MA
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