Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME0072627 | FL |
NPI | 1003844457 |
---|---|
Provider Name | Dr. Mary Anne Mcginn |
First Address | Pinellas Park, FL 33782-4338 |
Second Address | St Petersburg, FL 33744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |