Provider Demographics
NPI:1700940301
Name:MCGUNIGAL, THOMAS E (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:MCGUNIGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8879
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0879
Mailing Address - Country:US
Mailing Address - Phone:401-572-3120
Mailing Address - Fax:401-572-3351
Practice Address - Street 1:116 EDDIE DOWLING HWY
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-7327
Practice Address - Country:US
Practice Address - Phone:401-766-0800
Practice Address - Fax:401-765-5904
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI8459208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7003442Medicaid
337887OtherTUFTS HEALTH PLAN
RI400764OtherBLUECHIP
RI22422OtherBLUECROSS BLUESHIELD
2300098OtherUNITED HEALTH
711120OtherHARVARD PILGRIM
RI7003442Medicaid
RI007008901Medicare PIN