Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 0101230848 | VA |
NPI | 1003872581 |
---|---|
Provider Name | Jennifer L Maguire |
First Address | Baltimore, MD 21297-1334 |
Second Address | Purcellville, VA 20132-6198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 16/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H43110 | (02) |