Provider Demographics
NPI:1467550012
Name:MACDONALD, DUSTEN MALCOLM (MD)
Entity Type:Individual
Prefix:DR
First Name:DUSTEN
Middle Name:MALCOLM
Last Name:MACDONALD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2700 DOLBEER ST
Mailing Address - Street 2:9040 FITZSIMMONS DRIVE
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-4736
Mailing Address - Country:US
Mailing Address - Phone:707-269-4229
Mailing Address - Fax:707-269-3849
Practice Address - Street 1:MADIGAN ARMY MEDICAL CTR
Practice Address - Street 2:9040 FITZSIMMONS DRIVE
Practice Address - City:JOINT BASE LEWIS MCCHORD
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-11-08
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Provider Licenses
StateLicense IDTaxonomies
CA1446772085R0001X
WA604302762085R0001X
ID127772085R0001X
MO20060099292085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology