Provider Demographics
NPI:1497838973
Name:DOWNEY, MARY E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:DOWNEY
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:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24435-0405
Mailing Address - Country:US
Mailing Address - Phone:540-377-2156
Mailing Address - Fax:540-377-9476
Practice Address - Street 1:33 RED HILL RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:VA
Practice Address - Zip Code:24435-0405
Practice Address - Country:US
Practice Address - Phone:540-377-2156
Practice Address - Fax:540-377-9476
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840286363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0110840286OtherSTATE LICENSURE
VAMD1054751OtherDEA #