Provider Demographics
NPI:1821079781
Name:MCGLOWAN, JAMES T (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:MCGLOWAN
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 1:49 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2878
Mailing Address - Country:US
Mailing Address - Phone:781-618-1944
Mailing Address - Fax:781-618-1947
Practice Address - Street 1:49 PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2878
Practice Address - Country:US
Practice Address - Phone:781-618-1944
Practice Address - Fax:781-618-1947
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA210655207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0174751Medicaid
MA0174751Medicaid
H66749Medicare UPIN