Provider Demographics
NPI:1063674562
Name:MAGUIRE, LILLIAS HOLMES (MD)
Entity Type:Individual
Prefix:
First Name:LILLIAS
Middle Name:HOLMES
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LILLIAS
Other - Middle Name:C
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:4TH FLOOR SILVERSTEIN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-662-2078
Mailing Address - Fax:215-615-0471
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:4TH FLOOR SILVERSTEIN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-2078
Practice Address - Fax:215-615-0471
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD475304208600000X, 208C00000X
MI4301111770208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery