Provider Demographics
NPI:1053007435
Name:MCGILVRAY, JAMES BRIAN
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:MCGILVRAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25008 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1361
Mailing Address - Country:US
Mailing Address - Phone:440-243-2995
Mailing Address - Fax:
Practice Address - Street 1:25008 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:OLMSTED TWP
Practice Address - State:OH
Practice Address - Zip Code:44138-1361
Practice Address - Country:US
Practice Address - Phone:440-243-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications