Provider Demographics
NPI:1003850744
Name:DOWNEY, MARK C (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:C
Last Name:DOWNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:119 BULIFANTS BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188
Mailing Address - Country:US
Mailing Address - Phone:757-564-7337
Mailing Address - Fax:757-564-3205
Practice Address - Street 1:119 BULIFANTS BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5709
Practice Address - Country:US
Practice Address - Phone:757-564-7337
Practice Address - Fax:757-564-3205
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101231481208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
010126088OtherVA PREMIERE HEALTH PLAN
VA010126088Medicaid
41203OtherSENTARA/OPTIMA
12-02789OtherUNITED HEALTHCARE
54-1778786OtherPHCS
54-1778786OtherCCN
6731745OtherCIGNA
54-1778786OtherFIRST HEALTH/MAIL HANDLER
7557155OtherAETNA TRADITIONAL
54-1778786-032OtherCHAMPUS/TRICARE
2710497OtherAETNA HMO
54-1778786OtherMID ATLANTIC HEALTH SOLUT
249628OtherSOUTHERN HEALTH
8128044OtherMAMSI/MDIPA
153980OtherANTHEM
54-1778786OtherVA HEALTH NETWORK
H29692Medicare UPIN