Provider Demographics
NPI:1972548550
Name:MCGUIRE, PAUL FREDERICK (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:FREDERICK
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 1:117 E KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5201
Mailing Address - Country:US
Mailing Address - Phone:336-623-9711
Mailing Address - Fax:336-623-7660
Practice Address - Street 1:117 E KINGS HWY
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5201
Practice Address - Country:US
Practice Address - Phone:336-623-9711
Practice Address - Fax:336-623-7660
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98-00965207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6040659Medicaid
NC891172KMedicaid
VA6040659Medicaid
NC891172KMedicaid