Basic Information
Provider Information
NPI: 1730525346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCDOWELL
FirstName: ABIGAIL
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 601791
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282601791
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1730 KERNERSVILLE MEDICAL PKWY STE 201
Address2:  
City: KERNERSVILLE
State: NC
PostalCode: 272847198
CountryCode: US
TelephoneNumber: 3369967001
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/22/2013
LastUpdateDate: 10/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X9473NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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