Provider Demographics
NPI:1922005255
Name:DOWLING, SALLY HAMEL (MD)
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:HAMEL
Last Name:DOWLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 N WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-7514
Mailing Address - Country:US
Mailing Address - Phone:302-436-8004
Mailing Address - Fax:302-436-9769
Practice Address - Street 1:15 N WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-9659
Practice Address - Country:US
Practice Address - Phone:302-436-8004
Practice Address - Fax:302-436-9769
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003949207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000432201Medicaid
00B210S04Medicare PIN
DE0000432201Medicaid