Provider Demographics
NPI:1558510792
Name:MACDONALD, JAMES ATHANASIUS V (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ATHANASIUS
Last Name:MACDONALD
Suffix:V
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:417 STATE ST
Mailing Address - Street 2:WEBBER WEST, SUITE 141
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6630
Mailing Address - Country:US
Mailing Address - Phone:207-973-4670
Mailing Address - Fax:207-973-4669
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:WEBBER WEST, SUITE 141
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6630
Practice Address - Country:US
Practice Address - Phone:207-973-4670
Practice Address - Fax:207-973-4669
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2022-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEMD19475207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN255580001Medicare PIN