Basic Information
| Provider Information | |||||||||
| NPI: | 1114142304 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT L MCGHIE MD PROFESSIONAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5939 | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934565939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059287951 | ||||||||
| FaxNumber: | 8059286839 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 S PALISADE DR | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934548901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059287951 | ||||||||
| FaxNumber: | 8059286839 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2007 | ||||||||
| LastUpdateDate: | 04/05/2011 | ||||||||
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| AuthorizedOfficialLastName: | MCGHIE | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8059287951 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | G53248 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | RN374415 | 01 | CA | NURSE PRACTITIONER | OTHER |