Provider Demographics
NPI:1083649768
Name:DOWDALL, MICHELLE MARIE (PA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:DOWDALL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 ARRINGDON PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5676
Mailing Address - Country:US
Mailing Address - Phone:919-660-5066
Mailing Address - Fax:919-929-3860
Practice Address - Street 1:5601 ARRINGDON PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5676
Practice Address - Country:US
Practice Address - Phone:919-660-5066
Practice Address - Fax:919-660-5044
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103185363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCA2725Medicare PIN
NC2756178Medicare ID - Type Unspecified