Provider Demographics
NPI:1992713606
Name:MCDONALD, AMY ANN (MD)
Entity type:Individual
Prefix:
First Name:AMY ANN
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:MHMC-SURGERY/TRAUMA/BURN/CRIT CARE
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:216-778-5478
Mailing Address - Fax:216-778-1350
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:MHMC-SURGERY/TRAUMA/BURN/CRIT CARE
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-5478
Practice Address - Fax:216-778-1350
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350738912086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2252726Medicaid
OH2252726Medicaid
OHMC7288631Medicare ID - Type Unspecified