Individual
MATTHEW MAGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6060
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN674797
PA
363LA2100X
Acute Care Nurse Practitioner
Primary
SP025613
PA
Other
Enumeration date
04/08/2022
Last updated
05/16/2022
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