Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 01065621A | IN |
N | 2086S0105X | Surgery of the Hand | 49807 | MN |
NPI | 1053503466 |
---|---|
Provider Name | Douglas Justin Mcguirk |
First Address | Terre Haute, IN 47807-4214 |
Second Address | Terre Haute, IN 47804-4010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2007 |
Last Update Date | 20/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00718154 | RAILROAD MEDICARE (01) | IN |
P00866722 | RAILROAD MEDICARE (01) | IN |