Individual
MR. PETER RUSSELL MCGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDIV, LCAS
Contact information
Practice address
847 W LAKE DR, MOUNT AIRY, NC 27030-2157
(336) 783-6919
Mailing address
284 EXECUTIVE PARK DR STE 200, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2047
NC
Other
Enumeration date
11/23/2010
Last updated
02/18/2019
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