1467594713 NPI number — DR. MARGUERITE L MCGARVEY MD

Table of content: DR. MARGUERITE L MCGARVEY MD (NPI 1467594713)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467594713 NPI number — DR. MARGUERITE L MCGARVEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGARVEY
Provider First Name:
MARGUERITE
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467594713
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2360 MARYLAND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLOW GROVE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19090-1709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-657-6776
Provider Business Mailing Address Fax Number:
267-913-5962

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2360 MARYLAND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLOW GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-657-6776
Provider Business Practice Location Address Fax Number:
215-366-3339
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  MD427114 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7214901 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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