Provider Demographics
NPI:1194747121
Name:MCGUIRK, ROBERT ALAN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALAN
Last Name:MCGUIRK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WASHINGTON STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4769
Mailing Address - Country:US
Mailing Address - Phone:781-380-0700
Mailing Address - Fax:781-380-0974
Practice Address - Street 1:400 WASHINGTON STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4769
Practice Address - Country:US
Practice Address - Phone:781-380-0700
Practice Address - Fax:781-380-0974
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37316207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9724095Medicaid
MA9724095Medicaid
M13335Medicare ID - Type Unspecified