Provider Demographics
NPI:1346870128
Name:MACDONALD, MARGARET A (PA-C)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-4025
Mailing Address - Country:US
Mailing Address - Phone:419-604-8299
Mailing Address - Fax:
Practice Address - Street 1:140 COLEMANS XING # 100
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-7080
Practice Address - Country:US
Practice Address - Phone:937-578-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006309RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant