Provider Demographics
NPI:1457443707
Name:DOWDY, AMY W (DO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:W
Last Name:DOWDY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:252 RURAL ACRES DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3503
Mailing Address - Country:US
Mailing Address - Phone:304-252-8551
Mailing Address - Fax:304-252-1790
Practice Address - Street 1:252 RURAL ACRES DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3503
Practice Address - Country:US
Practice Address - Phone:304-252-8551
Practice Address - Fax:304-252-1790
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2051207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
439598OtherCARELINK
WV0035054003Medicaid
WV98425Medicaid
WV3810006293Medicaid
WVI64173Medicare ID - Type UnspecifiedUGS MEDICARE
WV98425Medicaid
WV3810006293Medicaid
I64173Medicare UPIN
WV0035054003Medicaid
DO2027915Medicare PIN
DO2027916Medicare PIN