Doctor Name: | DR. KATHLEEN M DONAHUE |
NPI Number: | 1851575070 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 005126 |
Business Practice Address: | Bldg 2238 Vandergrift Blvd Naval Resources Mgmt, Attn Medical Staff Service, Denta Camp Pendleton, CA - 920555221 |
Business Phone Number: | 9282693808 |
Business Fax Number: | 9282693994 |
Mailing Address: | Marine Wing Support Squadron 371, Po Box 99210 YUMA |
State: | AZ |
Postal Code: | 85369 |
Phone Number: | 9282693808 |
Fax Number: | 9282693994 |
NPI Enumeration Date: | 12/24/2007 |
NPI Last Update Date: | 12/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 005126 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |