Basic Information
| Provider Information | |||||||||
| NPI: | 1770544363 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAGUIRE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | HARVEY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 FRANCIS ST | ||||||||
| Address2: | ROOM PBBA-408 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177328881 | ||||||||
| FaxNumber: | 6177326829 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 CYPRESS ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024456002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8573070896 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 07/05/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 42948 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 4091990000 | 05 | MD | MEDICAID | S062-0278 | 01 | MD | BC/BS REGIONAL | OTHER | 648753-01 | 01 | MD | BC/BS | OTHER |