Provider Demographics
NPI:1992994925
Name:ANDERSON, INGRID MCDOWELL (MD)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:MCDOWELL
Last Name:ANDERSON
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 1:11100 EUCLID AVE
Mailing Address - Street 2:C/O DEPARTMENT OF PEDIATRIC CRITICAL CARE
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-3310
Mailing Address - Fax:216-844-5122
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:C/O DEPARTMENT OF PEDIATRIC CRITICAL CARE
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3310
Practice Address - Fax:216-844-5122
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57013451208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics