Provider Demographics
NPI:1144280322
Name:MCGINNESS, MARILEE KAY (MD)
Entity type:Individual
Prefix:DR
First Name:MARILEE
Middle Name:KAY
Last Name:MCGINNESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2160 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1410
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:20 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2493
Practice Address - Country:US
Practice Address - Phone:828-274-7502
Practice Address - Fax:828-271-6599
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-20475174400000X
NC2016-01825208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4582319OtherAETNA
NC1173006OtherGATEWAY
NC3234091OtherCIGNA
NCP01778521OtherRR MEDICARE
NC1144280322Medicaid
KS100206770AMedicaid
NC3234091OtherCIGNA
NC4582319OtherAETNA
KS021401Medicare PIN