Provider Demographics
NPI:1992836332
Name:MCDONOUGH, MARGARET MARY T (DO)
Entity Type:Individual
Prefix:DR
First Name:MARGARET MARY
Middle Name:T
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1630 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2791
Practice Address - Country:US
Practice Address - Phone:410-604-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0047890207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD968690800Medicaid
MDC02698Medicare UPIN
MD968690800Medicaid