Provider Demographics
NPI:1962471482
Name:MAGAN, MICHAEL O (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:O
Last Name:MAGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 SISTER PIERRE DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7516
Mailing Address - Country:US
Mailing Address - Phone:410-337-9003
Mailing Address - Fax:410-337-9005
Practice Address - Street 1:120 SISTER PIERRE DR
Practice Address - Street 2:SUITE 303
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7516
Practice Address - Country:US
Practice Address - Phone:410-337-9003
Practice Address - Fax:410-337-9005
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2010-08-30
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Provider Licenses
StateLicense IDTaxonomies
MDD0012429207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D76533Medicare UPIN