Basic Information
| Provider Information | |||||||||
| NPI: | 1740252105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDOWELL | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2853 GRANDE OAKS WAY | ||||||||
| Address2: | |||||||||
| City: | FLEMING ISLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320033769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012397211 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1825 KINGSLEY AVE STE 250 | ||||||||
| Address2: | |||||||||
| City: | ORANGE PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320734478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042762549 | ||||||||
| FaxNumber: | 9042769235 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2006 | ||||||||
| LastUpdateDate: | 11/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 282387 | MA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 0101232142 | VA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | ME153243 | FL | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.