Provider Demographics
NPI:1376639237
Name:DOWNING, MARY CAROLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CAROLYN
Last Name:DOWNING
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 1:1101 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-5502
Mailing Address - Country:US
Mailing Address - Phone:912-350-7171
Mailing Address - Fax:912-350-3454
Practice Address - Street 1:1101 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-5502
Practice Address - Country:US
Practice Address - Phone:912-350-7171
Practice Address - Fax:912-350-3454
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.204487207RC0000X
GA058410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2149148Medicaid
GA452476642GMedicaid
GAP01048150OtherRAILROAD MEDICARE
GA452476642DMedicaid
GA452476642HMedicaid
MS07227344Medicaid
SCG58410Medicaid
GA452476642JMedicaid
GA452476642FMedicaid
GA452476642EMedicaid
LA2149148Medicaid
LA4Q1227061Medicare PIN
GA202I111448Medicare PIN
GA452476642HMedicaid
MS07227344Medicaid
GA511I110938Medicare PIN