Provider Demographics
NPI:1730278839
Name:MCDOWELL, SUSAN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FIVE FORK PLAZA CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5462
Mailing Address - Country:US
Mailing Address - Phone:864-458-7008
Mailing Address - Fax:864-458-7002
Practice Address - Street 1:7 FIVE FORK PLAZA CT
Practice Address - Street 2:SUITE D
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5462
Practice Address - Country:US
Practice Address - Phone:864-458-7008
Practice Address - Fax:864-458-7002
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1871680728OtherGROUP NPI
SC7632OtherMEDICARE GROUP PIN
SC7632OtherMEDICARE GROUP PIN