Doctor Name: | RUTH A. MCDOWELL |
NPI Number: | 1619069606 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 5601002684 |
Business Practice Address: | 930 Blue Star Hwy South Haven, MI - 490907758 |
Business Phone Number: | 2696371115 |
Business Fax Number: | 2696391314 |
Mailing Address: | 930 Blue Star Hwy, SOUTH HAVEN |
State: | MI |
Postal Code: | 490907758 |
Phone Number: | 2696371115 |
Fax Number: | 2696391314 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 04/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 5601002684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |