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NPI Code Detail

MEDICARE: MGMC LLC

MEDICARE: MGMC LLC
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
12084P0800XPsychiatry Physician

Other Identifiers

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

General Provider Information

NPI Number : 1316949654
Entity Type Code : Organization
Provider Name (Legal Business Name) : MGMC LLC
Provider Business Mailing Address
First Line : PO BOX 418407
Second Line :
City : BOSTON
State : MA
Zip : 02241-8407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3800 RESERVOIR RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20007-2113
Country : US
Telephone Number : 888-896-1400
Fax Number :
Authorized Official
Title or Position : VP
Name : STEPHANIE SCHNEIDER
Credential :
Telephone Number : 703-558-1403
Provider Enumeration Date : 06/01/2005
Last Update Date : 03/28/2024

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Directions to “MGMC LLC ” Practice Location

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