Provider Demographics
NPI:1922268929
Name:MCGUIGAN, DAVID (PT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MCGUIGAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3700 FLEET ST STE 109
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4238
Practice Address - Country:US
Practice Address - Phone:443-438-7214
Practice Address - Fax:443-438-7821
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27454225100000X, 225100000X
PAPT-021034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2592753OtherHIGHMARK PA BLUE SHIELD
DE1922268929Medicaid
3634068000OtherIBC AMERIHEALTH
PA102564590-0001Medicaid
PA2592753OtherHIGHMARK PA BLUE SHIELD
PA102564590-0001Medicaid