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Individual

MICHAEL WAYNE MCGUIRE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NAVY SFIDC

Contact information

Practice address
4749 67TH ST APT B, SAN DIEGO, CA 92115-2935
(602) 690-3145
Mailing address
4749 67TH ST APT B, SAN DIEGO, CA 92115-2935

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
04/30/2019
Last updated
04/30/2019
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