Doctor Name: | KELLY WAYNE MCGUIRE |
NPI Number: | 1023063682 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 01060309 |
Business Practice Address: | 6301 University Commons Suite 310 South Bend, IN - 466351571 |
Business Phone Number: | 5742321471 |
Business Fax Number: | 5742398511 |
Mailing Address: | 6301 University Commons, Ste 230 SOUTH BEND |
State: | IN |
Postal Code: | 466351571 |
Phone Number: | 5742512100 |
Fax Number: | 5742512151 |
NPI Enumeration Date: | 05/23/2006 |
NPI Last Update Date: | 09/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 01060309 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |