Individual
DR. BRIAN PATRICK MAGWIRE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
407 W MAUMEE ST, ANGOLA, IN 46703-1428
(260) 665-5918
(260) 665-5918
Mailing address
407 W MAUMEE ST, ANGOLA, IN 46703-1428
(260) 665-5918
(260) 665-5918
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002144B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000305660
BLUECROSS BLUESHIELD PIN
IN
01
—
4492730001
DMERC
IN
Enumeration date
11/10/2005
Last updated
07/08/2007
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