Provider Demographics
NPI:1306821749
Name:MACDOWELL, ANA LUIZA (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LUIZA
Last Name:MACDOWELL
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:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:5085 MORGANTON RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1523
Practice Address - Country:US
Practice Address - Phone:910-323-3890
Practice Address - Fax:910-323-4509
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200501495207K00000X
NC2005-01495207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2046091AOtherMEDICARE PTAN
NC1306821749Medicaid
NC5902559Medicaid
NC2046091AOtherMEDICARE PTAN
140MJOtherBLUE CROSS
NC3381829OtherCIGNA
SCQ95007Medicaid
182866OtherMEDCOST
806744OtherPARTNERS
806744OtherPARTNERS
NC5902559Medicaid
VA1306821749Medicaid