Provider Demographics
NPI:1922112820
Name:MCGRATH, ST. JOHN D (MD)
Entity Type:Individual
Prefix:
First Name:ST. JOHN
Middle Name:D
Last Name:MCGRATH
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 1:28 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:SOUTHWICK
Mailing Address - State:MA
Mailing Address - Zip Code:01077-9523
Mailing Address - Country:US
Mailing Address - Phone:413-747-5566
Mailing Address - Fax:
Practice Address - Street 1:780 CHESTNUT ST
Practice Address - Street 2:SUITE 30
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1610
Practice Address - Country:US
Practice Address - Phone:413-747-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78054207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease