Provider Demographics
NPI:1073718128
Name:MCINTYRE, DONALD G (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6338 37TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:RUGBY
Mailing Address - State:ND
Mailing Address - Zip Code:58368-8765
Mailing Address - Country:US
Mailing Address - Phone:701-583-2587
Mailing Address - Fax:
Practice Address - Street 1:6338 37TH AVE NE
Practice Address - Street 2:
Practice Address - City:RUGBY
Practice Address - State:ND
Practice Address - Zip Code:58368-8765
Practice Address - Country:US
Practice Address - Phone:701-583-2587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine