Provider Demographics
NPI:1750491130
Name:DOWELL, GEORGE H (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:H
Last Name:DOWELL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:11477 OLDE CABIN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7130
Mailing Address - Country:US
Mailing Address - Phone:314-997-5208
Mailing Address - Fax:314-997-5368
Practice Address - Street 1:11477 OLDE CABIN RD STE 210
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7129
Practice Address - Country:US
Practice Address - Phone:314-997-5208
Practice Address - Fax:314-997-5368
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO321842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200684301Medicaid
MO1542950OtherUNITED HEALTHCARE
MO27115OtherBLUE CROSS BLUE SHIELD
MO826263130OtherRR MEDICARE
MO100737OtherHEALTHLINK
MO826263130OtherRR MEDICARE
MOA09743Medicare UPIN