Provider Demographics
NPI:1982650966
Name:MCGUIGAN, LAWRENCE A III (PA-C)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:A
Last Name:MCGUIGAN
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225
Mailing Address - Country:US
Mailing Address - Phone:410-350-3200
Mailing Address - Fax:
Practice Address - Street 1:2900 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225
Practice Address - Country:US
Practice Address - Phone:410-350-8336
Practice Address - Fax:410-350-7178
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC03009363AS0400X
MDC0003009363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ33915Medicare UPIN