MEDICARE: DR. MICHAEL G MCGRATH OD

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	152W00000X	Optometrist	1009TX	WA

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	:	1326223470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL G MCGRATH OD

Provider Business Mailing Address
First Line	:	1580 WOODRIDGE DR SE
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-3818
Country	:	US
Telephone Number	:	360-871-7837
Fax Number	:	360-871-7901

Provider Business Practice Location Address
First Line	:	1580 WOODRIDGE DR SE
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-3818
Country	:	US
Telephone Number	:	360-871-7837
Fax Number	:	360-871-7901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	02/28/2008

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