Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 5101017352 | MI |
NPI | 1588860373 |
---|---|
Provider Name | Vincent Charles Mcginniss |
First Address | Melbourne, FL 32940-6058 |
Second Address | Melbourne, FL 32935-5958 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 10/03/2016 |