Provider Demographics
NPI:1922050145
Name:MAGLIONE, ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:MAGLIONE
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 1:417 JOHN S MOSBY DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-7122
Mailing Address - Country:US
Mailing Address - Phone:910-397-0626
Mailing Address - Fax:
Practice Address - Street 1:2032 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6677
Practice Address - Country:US
Practice Address - Phone:910-202-1071
Practice Address - Fax:910-343-4275
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00625207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8953716Medicaid
NC8953716Medicaid
NC2227891FMedicare PIN
NCA63767Medicare UPIN