Provider Demographics
NPI:1164041661
Name:MCGUIRE, PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-2627
Mailing Address - Country:US
Mailing Address - Phone:253-344-8284
Mailing Address - Fax:
Practice Address - Street 1:205 SOUTH FRONT STREET
Practice Address - Street 2:BRADY 3
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104
Practice Address - Country:US
Practice Address - Phone:253-344-8284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT221739207P00000X, 390200000X
NH24193207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program