# MINIMALLY INVASIVE CARE INSTITUTE OF PHILADELPHIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083144943
- **Authorized official:** JAMES F MCGUCKIN MD (CEO)
- **Authorized official phone:** (215) 240-6007

## Contact information

- **Practice address:** 4220 MARKET ST FL 2, PHILADELPHIA, PA 19104-3007
- **Practice address phone:** (215) 240-6007
- **Practice address fax:** (215) 240-6373
- **Mailing address:** 4220 MARKET ST FL 2, PHILADELPHIA, PA 19104-3007
- **Mailing address phone:** (215) 240-6007
- **Mailing address fax:** (215) 240-6373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0011X | Interventional Cardiology Physician | — | NULL | — |
| 207RI0011X | Interventional Cardiology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/14/2017
- **Last updated:** 05/19/2021