Provider Demographics
NPI:1386613818
Name:MCGUIRE, WARREN A (MD)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:A
Last Name:MCGUIRE
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 1:1580 BEAM AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1127
Mailing Address - Country:US
Mailing Address - Phone:651-779-7978
Mailing Address - Fax:651-779-7656
Practice Address - Street 1:1580 BEAM AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1127
Practice Address - Country:US
Practice Address - Phone:651-779-7978
Practice Address - Fax:651-779-7656
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN357572085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN109109OtherUCARE MN
MN2428639OtherMEDICA
WI32478900Medicaid
MN3T999MCOtherBLUE CROSS BLUE SHIELD MN
MN1012219OtherPREFERREDONE
MN768258OtherAMERICA'S PPO
MN603765800Medicaid
MNHP22131OtherHEALTHPARTNERS
MN920000111Medicare ID - Type UnspecifiedMN MEDICARE
WI32478900Medicaid
MN603765800Medicaid