# MINIMALLY INVASIVE CARE INSTITUTE OF MAIN LINE LLC

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

## Provider details

- **NPI number:** 1568992295
- **Authorized official:** JAMES MCGUCKIN MD (CEO)
- **Authorized official phone:** (484) 808-5220

## Contact information

- **Practice address:** 700 S HENDERSON RD STE 225, KING OF PRUSSIA, PA 19406-3530
- **Practice address phone:** (484) 808-5220
- **Mailing address:** 700 S HENDERSON RD STE 225, KING OF PRUSSIA, PA 19406-3530
- **Mailing address phone:** (484) 808-5220
- **Mailing address fax:** (484) 679-1821

## 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 | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/15/2017
- **Last updated:** 05/19/2021