Provider Demographics
NPI:1346265170
Name:MCGUE, JOHN G (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:G
Last Name:MCGUE
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 1:1241 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3288
Mailing Address - Country:US
Mailing Address - Phone:843-881-4020
Mailing Address - Fax:
Practice Address - Street 1:1241 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3288
Practice Address - Country:US
Practice Address - Phone:843-881-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043468A2085R0202X, 2085R0204X
NC2014-024902085R0202X, 2085R0204X
SCMD239062085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8683OtherMEDICARE GROUP
SC1709OtherMEDICARE GROUP
SC1709OtherMEDICARE GROUP
SC8683OtherMEDICARE GROUP
G12535Medicare UPIN
MI3221453OtherMEDICAID