Provider Demographics
NPI:1508288994
Name:MCGUIRE, RONDA
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:
Last Name:MCGUIRE
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 1:6168 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1313
Mailing Address - Country:US
Mailing Address - Phone:810-835-6255
Mailing Address - Fax:
Practice Address - Street 1:4100 BEECHER RD STE A
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3661
Practice Address - Country:US
Practice Address - Phone:810-342-3813
Practice Address - Fax:810-342-3784
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-20
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704219202363L00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine