Provider Demographics
NPI:1992882625
Name:MAGUIRE, DOUGLAS G (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:G
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1501 MAIN ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-2084
Mailing Address - Country:US
Mailing Address - Phone:978-851-9055
Mailing Address - Fax:978-851-9033
Practice Address - Street 1:1501 MAIN ST
Practice Address - Street 2:UNIT 2
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-4725
Practice Address - Country:US
Practice Address - Phone:978-851-9055
Practice Address - Fax:978-851-9033
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA351252OtherHARVARD PILGRIM HC
MAY36622OtherBCBS
MA4402697OtherUNITED HC
MA9092398OtherCIGNA
MAY36622OtherBCBS
MAU92751Medicare UPIN