Provider Demographics
NPI:1871015578
Name:MAGRUDER MEDICAL GROUP LTD
Entity Type:Organization
Organization Name:MAGRUDER MEDICAL GROUP LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:T
Authorized Official - Last Name:ALMENDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-734-3131
Mailing Address - Street 1:615 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-2001
Mailing Address - Country:US
Mailing Address - Phone:419-734-3131
Mailing Address - Fax:419-732-8145
Practice Address - Street 1:611 FULTON ST STE E
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-2008
Practice Address - Country:US
Practice Address - Phone:419-734-4539
Practice Address - Fax:419-734-6365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:H.B. MAGRUDER MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-13
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty