Provider Demographics
NPI:1821676826
Name:MCDONALD, KARL EUGENE
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:EUGENE
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 PARKWAY TERRACE DR APT 5
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2555
Mailing Address - Country:US
Mailing Address - Phone:202-425-2188
Mailing Address - Fax:
Practice Address - Street 1:3408 PARKWAY TERRACE DR APT 5
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-2555
Practice Address - Country:US
Practice Address - Phone:202-425-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant