Provider Demographics
NPI:1275378531
Name:MCDOWELL, MARY ANGIE
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANGIE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W EUREKA ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4738
Mailing Address - Country:US
Mailing Address - Phone:419-231-5307
Mailing Address - Fax:
Practice Address - Street 1:523 W EUREKA ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4737
Practice Address - Country:US
Practice Address - Phone:419-231-5307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide