Provider Demographics
NPI:1093863748
Name:DOWDING-HARRIS, MARY LOUISE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:LOUISE
Last Name:DOWDING-HARRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:LOUISE
Other - Last Name:DOWDING-HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAN ASSISTANT
Mailing Address - Street 1:3955 PATIENT CARE WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4299
Mailing Address - Country:US
Mailing Address - Phone:517-882-6643
Mailing Address - Fax:517-882-1949
Practice Address - Street 1:3955 PATIENT CARE WAY
Practice Address - Street 2:SUITE B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4299
Practice Address - Country:US
Practice Address - Phone:517-882-6643
Practice Address - Fax:517-882-1949
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant