Provider Demographics
NPI:1932157203
Name:MAGAURAN, RAYMOND G (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:G
Last Name:MAGAURAN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:55 SAINT GEORGE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3333
Mailing Address - Country:US
Mailing Address - Phone:413-276-4543
Mailing Address - Fax:413-304-3838
Practice Address - Street 1:55 SAINT GEORGE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3333
Practice Address - Country:US
Practice Address - Phone:413-276-4543
Practice Address - Fax:413-304-3838
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2016-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA73080207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9713191Medicaid
MA9713191Medicaid
MAE59653Medicare UPIN