Provider Demographics
NPI:1346423761
Name:MACGUIRE, MARY E (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:MACGUIRE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1450 E A ST
Mailing Address - Street 2:STE 3
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2239
Mailing Address - Country:US
Mailing Address - Phone:307-473-7821
Mailing Address - Fax:307-473-7522
Practice Address - Street 1:1450 E A ST
Practice Address - Street 2:STE 3
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2239
Practice Address - Country:US
Practice Address - Phone:307-473-7821
Practice Address - Fax:307-473-7522
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY4639A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW305440Medicare PIN
WYD37214Medicare UPIN