Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 26641 | WV |
NPI | 1225264203 |
---|---|
Provider Name | Dr. John Lawson Magruder |
First Address | Morgantown, WV 26506-9214 |
Second Address | Morgantown, WV 26506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2009 |
Last Update Date | 08/04/2021 |