Provider Demographics
NPI:1235146630
Name:MCGHEE, SILAS JAMES (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SILAS
Middle Name:JAMES
Last Name:MCGHEE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:1199 HADLEY RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1788
Practice Address - Country:US
Practice Address - Phone:317-831-2273
Practice Address - Fax:317-831-9347
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000616A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300007330Medicaid
IN000000356208OtherANTHEM PIN NUMBER
INP00456861OtherMEDICARE RAILROAD PIN NUMBER
IN677730OOMedicare PIN
INP81914Medicare UPIN