Provider Demographics
NPI:1649338096
Name:MCGUIRE, JANET LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LYNN
Other - Last Name:GRABOFSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:11350 MCCORMICK ROAD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:410-329-1071
Mailing Address - Fax:410-329-1054
Practice Address - Street 1:1741 WILLIAMSPORT PIKE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-4341
Practice Address - Country:US
Practice Address - Phone:304-596-2378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102167363A00000X
WV1523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054282200Medicaid
FLP72426Medicare UPIN
FLE84954Medicare ID - Type Unspecified