Provider Demographics
NPI:1306855473
Name:DOONG, NANCY SUZZANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SUZZANNE
Last Name:DOONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:SUZANNE
Other - Last Name:SNOWBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 758963
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-8963
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:5900 CEDAR LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3635
Practice Address - Country:US
Practice Address - Phone:443-718-4067
Practice Address - Fax:443-718-4068
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002689363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD316110ZDDBMedicare PIN
MD320MR672Medicare PIN
MD316110YVZMedicare PIN