MEDICARE: TONY MAGLIONE MD,PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	96-00625	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124441654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TONY MAGLIONE MD,PLLC

Provider Business Mailing Address
First Line	:	417 JOHN S MOSBY DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-7122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2032 S 17TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-6677
Country	:	US
Telephone Number	:	910-202-1071
Fax Number	:	910-343-4275

Authorized Official
Title or Position	:	MD
Name	:	ANTHONY MAGLIONE
Credential	:
Telephone Number	:	910-397-0626

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	02/04/2014

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