Basic Information
Provider Information
NPI: 1255500062
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGUIRE
FirstName: DAVID
MiddleName: FRANCIS
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 12248
Address2:  
City: NEW BERN
State: NC
PostalCode: 285612248
CountryCode: US
TelephoneNumber: 2525146685
FaxNumber: 2525142745
Practice Location
Address1: 1040 MEDICAL PARK AVE
Address2:  
City: NEW BERN
State: NC
PostalCode: 285625248
CountryCode: US
TelephoneNumber: 2526331678
FaxNumber: 2526331403
Other Information
ProviderEnumerationDate: 02/26/2008
LastUpdateDate: 06/14/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X0010-01277NCY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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