Provider Demographics
NPI:1659339174
Name:MCDOWELL, ROBERT WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:189 PROUTY DR
Practice Address - Street 2:NORTH COUNTRY HOSPITAL
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9326
Practice Address - Country:US
Practice Address - Phone:802-334-3222
Practice Address - Fax:802-334-3230
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0006642207ZP0102X
NH6444207ZP0102X
WV21087207ZP0102X
PAMD421311207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0005442Medicaid
NH81225442Medicaid
VT0005442Medicaid
C65628Medicare UPIN
NH81225442Medicaid