MEDICARE: WESTERN MARYLAND EYE SURGICAL CENTER,PHILIP MCGANN, M.D., 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
1	261QS0132X	Ophthalmologic Surgery Clinic/Center	D00029921	MD

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	:	1902991979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN MARYLAND EYE SURGICAL CENTER,PHILIP MCGANN, M.D., PA

Provider Business Mailing Address
First Line	:	1003 W 7TH ST
Second Line	:	SUITE 400
City	:	FREDERICK
State	:	MD
Zip	:	21701-4106
Country	:	US
Telephone Number	:	301-662-3721
Fax Number	:	301-698-8164

Provider Business Practice Location Address
First Line	:	1003 W 7TH ST
Second Line	:	SUITE 400
City	:	FREDERICK
State	:	MD
Zip	:	21701-4106
Country	:	US
Telephone Number	:	301-662-3721
Fax Number	:	301-698-8164

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. PHILIP JOHN MCGANN
Credential	:	M.D.
Telephone Number	:	301-662-3721

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	03/06/2012

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