Provider Demographics
NPI:1417057795
Name:MAGUR, EDWARD G (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:G
Last Name:MAGUR
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 1:5454 WISCONSIN AVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6901
Mailing Address - Country:US
Mailing Address - Phone:301-657-1996
Mailing Address - Fax:301-951-6160
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6901
Practice Address - Country:US
Practice Address - Phone:301-657-1996
Practice Address - Fax:301-951-6160
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061976207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0785500001OtherADMINSTAR PROVIDER #
MD1455574000OtherUS DEPT OF LABOR PROVIDER
DC14520008OtherCARE1ST BC/BS PROVIDER #
MDH85764Medicare UPIN
DC14520008OtherCARE1ST BC/BS PROVIDER #