Provider Demographics
NPI:1457377582
Name:MAGUIRE, PATRICK DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:DAVID
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4574
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28406-1574
Mailing Address - Country:US
Mailing Address - Phone:910-251-1839
Mailing Address - Fax:910-251-8286
Practice Address - Street 1:1988 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6647
Practice Address - Country:US
Practice Address - Phone:910-662-8440
Practice Address - Fax:910-795-4826
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98017022085R0001X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2428887OtherUNITED HEALTHCARE
920005735OtherRAILROAD MEDICARE
1253ROtherBCBS
80808OtherMEDCOST
NC891253RMedicaid
920005735OtherRAILROAD MEDICARE
2428887OtherUNITED HEALTHCARE
H15149Medicare UPIN