Provider Demographics
NPI:1982986410
Name:MCGILL, JOHN KEVIN MICHAEL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KEVIN MICHAEL
Last Name:MCGILL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 SUNBURST HWY
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2546
Mailing Address - Country:US
Mailing Address - Phone:410-901-6290
Mailing Address - Fax:410-901-6295
Practice Address - Street 1:640 SUNBURST HWY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613
Practice Address - Country:US
Practice Address - Phone:410-901-6290
Practice Address - Fax:410-901-6295
Is Sole Proprietor?:No
Enumeration Date:2011-09-11
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003947183500000X
MD24379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist