Provider Demographics
NPI:1487652004
Name:MCQUISTON, MARGARET A
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:A
Last Name:MCQUISTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29159 HELMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-7003
Mailing Address - Country:US
Mailing Address - Phone:734-671-5100
Mailing Address - Fax:734-671-7664
Practice Address - Street 1:29159 HELMAN BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48183-7003
Practice Address - Country:US
Practice Address - Phone:734-671-5100
Practice Address - Fax:734-671-7664
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012342207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4072859Medicaid
MIG76854Medicare UPIN
MI0N33780001Medicare PIN