Provider Demographics
NPI:1588604193
Name:MCGILL, REGINA BERNADETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:BERNADETTE
Last Name:MCGILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:STE 201
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3900
Mailing Address - Fax:517-913-3901
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:STE 201
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-3900
Practice Address - Fax:517-913-3901
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301065738207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1001915OtherMCLAREN HEALTH PLAN-MEDICAID
MI200000002373OtherPHP
MI1103302861OtherBCBS/BCN
MI200000002373OtherPHP FAMILYCARE
MI0M21440005OtherMEDICARE ADVANTAGE
MI4083610Medicaid
MI1001915OtherMCLAREN HEALTH ADVANTAGE
MI4848098Medicaid
MI1001915OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI110169067OtherRAILROAD MEDICARE
MI5248555OtherAETNA
MI200000002373OtherPHP FAMILYCARE
MI4848098Medicaid