Provider Demographics
NPI:1023003944
Name:DOWELL, SUZY LEE (MD)
Entity Type:Individual
Prefix:
First Name:SUZY
Middle Name:LEE
Last Name:DOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 ALLENDALE RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1426
Mailing Address - Country:US
Mailing Address - Phone:610-265-9290
Mailing Address - Fax:610-265-2772
Practice Address - Street 1:491 ALLENDALE RD
Practice Address - Street 2:SUITE 121
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1426
Practice Address - Country:US
Practice Address - Phone:610-265-9290
Practice Address - Fax:610-265-2772
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070727L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD070727LOtherSTATE LICENSE NUMBER
PA0300054510001Medicaid
PA0300054510001Medicaid