Provider Demographics
NPI:1124108881
Name:DOLAN, MARGARET ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANNE
Last Name:DOLAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 MEDICAL PARK CT
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4347
Mailing Address - Country:US
Mailing Address - Phone:252-247-3476
Mailing Address - Fax:252-247-3478
Practice Address - Street 1:3608 MEDICAL PARK CT
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4347
Practice Address - Country:US
Practice Address - Phone:252-247-3476
Practice Address - Fax:252-247-3478
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104118363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC104118OtherNC STATE LICENSE
Q37036Medicare UPIN
2762980Medicare ID - Type Unspecified