Individual
MICHAEL ANTHONY MCGOURTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
93 THAMES ST, NEWPORT, RI 02840-2536
(401) 846-4150
(401) 846-9340
Mailing address
56 OAK ST, MIDDLETOWN, RI 02842-4945
(401) 829-2435
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA00221
RI
363AM0700X
Medical Physician Assistant
Primary
PAC00221
RI
Other
Enumeration date
12/01/2006
Last updated
12/21/2018
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