Provider Demographics
NPI:1326233990
Name:MCDONALD, MICHAEL JAMES (CO)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:CO
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Mailing Address - Street 1:498 DEEP RAVINE CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6083
Mailing Address - Country:US
Mailing Address - Phone:336-414-9198
Mailing Address - Fax:
Practice Address - Street 1:3303 HEALY DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1478
Practice Address - Country:US
Practice Address - Phone:336-765-2425
Practice Address - Fax:336-765-8370
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist