Provider Demographics
NPI:1851973440
Name:DONOVAN, MARGARET RITA
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:RITA
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 TRADITION VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1417
Mailing Address - Country:US
Mailing Address - Phone:704-942-4264
Mailing Address - Fax:
Practice Address - Street 1:10801 TRADITION VIEW DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1417
Practice Address - Country:US
Practice Address - Phone:704-942-4264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date: