Provider Demographics
NPI:1891880134
Name:MCINTYRE, ANGUS P JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGUS
Middle Name:P
Last Name:MCINTYRE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:85 HERRICK ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1790
Mailing Address - Country:US
Mailing Address - Phone:978-927-6850
Mailing Address - Fax:978-524-7917
Practice Address - Street 1:85 HERRICK ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1790
Practice Address - Country:US
Practice Address - Phone:978-927-6850
Practice Address - Fax:978-524-7917
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA49044207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE22684Medicare UPIN
MAJ08973Medicare PIN