Provider Demographics
NPI:1689669806
Name:MAGEE, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:MAGEE
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 1:1639 N VOLUSIA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-3843
Mailing Address - Country:US
Mailing Address - Phone:386-775-2012
Mailing Address - Fax:386-775-2013
Practice Address - Street 1:1639 N VOLUSIA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-3843
Practice Address - Country:US
Practice Address - Phone:386-775-2012
Practice Address - Fax:386-775-2013
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109560207X00000X
MDD0047177207X00000X
DCMD034714207X00000X
NY1940141207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004273500Medicaid
MD34101110Medicaid
FLFQ029ZMedicare PIN
FL004273500Medicaid
G09688Medicare UPIN