Provider Demographics
NPI:1407851967
Name:MCGUIRE, THOMAS EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EUGENE
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 1:2060 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-1926
Mailing Address - Country:US
Mailing Address - Phone:814-877-7711
Mailing Address - Fax:814-877-7715
Practice Address - Street 1:2060 N PEARL ST
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-1926
Practice Address - Country:US
Practice Address - Phone:814-877-7711
Practice Address - Fax:814-877-7715
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029963E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02146427OtherNY MEDICAL ASSISTANCE
PA184879OtherBLUE SHIELD
PA080192127OtherRR MEDICARE
PA205103OtherUPMC
PA3163638OtherAETNA
PA0009591970010Medicaid
PA75594OtherUNISON
PAP001038OtherGATEWAY
NY00026194201OtherUNIVERA
OH2223623OtherOH MEDICAL ASSISTANCE
PAP001038OtherGATEWAY
OH2223623OtherOH MEDICAL ASSISTANCE