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NPI Code Detail

MEDICARE: JAMES F MCGUCKIN MD OF MD PA

MEDICARE: JAMES F MCGUCKIN MD OF MD PA
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
12086S0129XVascular Surgery Physician
22085R0204XVascular & Interventional Radiology Physician

General Provider Information

NPI Number : 1730480872
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES F MCGUCKIN MD OF MD PA
Provider Business Mailing Address
First Line : 2929 ARCH ST
Second Line : SUITE 1750
City : PHILADELPHIA
State : PA
Zip : 19104-2866
Country : US
Telephone Number : 215-382-3680
Fax Number : 215-240-1677
Provider Business Practice Location Address
First Line : 3450 OLD WASHINGTON RD STE 202
Second Line :
City : WALDORF
State : MD
Zip : 20602-3250
Country : US
Telephone Number : 301-645-3590
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. SETH SHARPE
Credential :
Telephone Number : 215-382-3680
Provider Enumeration Date : 11/05/2010
Last Update Date : 05/26/2020

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