Provider Demographics
NPI:1235427261
Name:MCGUIRE, KEVIN K (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:K
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 1:1540 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NOVA SCOTIA
Mailing Address - Zip Code:B0P 1R0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1540 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NOVA SCOTIA
Practice Address - Zip Code:B0P 1R0
Practice Address - Country:CA
Practice Address - Phone:902-765-4494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20063207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1235427261Medicaid