Individual
MARY CLARK MAGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22590 SHADY CT, CALIFORNIA, MD 20619-5009
(301) 373-7900
(301) 373-6900
Mailing address
22590 SHADY CT, CALIFORNIA, MD 20619-5009
(301) 373-7900
(301) 373-6900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R130834
MD
363LF0000X
Family Nurse Practitioner
Primary
R130834
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444072200
—
MD
Enumeration date
08/01/2017
Last updated
04/19/2023
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