Provider Demographics
NPI:1194740712
Name:MCGRORY, BRUCE E (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:E
Last Name:MCGRORY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11835 FISHING POINT DR
Mailing Address - Street 2:STE 207
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-873-3334
Mailing Address - Fax:757-873-1128
Practice Address - Street 1:11835 FISHING POINT DR
Practice Address - Street 2:STE 207
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-873-3334
Practice Address - Fax:757-873-1128
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010550552080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G46744Medicare UPIN