Provider Demographics
NPI:1437319266
Name:MAGRO, TODD KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:KEITH
Last Name:MAGRO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1708 OLD TROLLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8076
Mailing Address - Country:US
Mailing Address - Phone:843-285-8555
Mailing Address - Fax:843-285-8657
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:726-228-0297
Practice Address - Fax:210-539-9400
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC309912084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC309918Medicaid
SC309918Medicaid