Basic Information
Provider Information
NPI: 1649699257
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWDALL
FirstName: HILARY
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: MB BCH BAO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1395 NW 167TH ST
Address2:  
City: MIAMI
State: FL
PostalCode: 331695710
CountryCode: US
TelephoneNumber: 4049655691
FaxNumber: 4049655710
Practice Location
Address1: 2084 HEADLAND DR
Address2:  
City: EAST POINT
State: GA
PostalCode: 303442135
CountryCode: US
TelephoneNumber: 4049655691
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/10/2014
LastUpdateDate: 10/30/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X77122GAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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