Provider Demographics
NPI:1740252105
Name:MCDOWELL, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2853 GRANDE OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-3769
Mailing Address - Country:US
Mailing Address - Phone:401-239-7211
Mailing Address - Fax:
Practice Address - Street 1:1825 KINGSLEY AVE STE 250
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4478
Practice Address - Country:US
Practice Address - Phone:904-276-2549
Practice Address - Fax:904-276-9235
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA282387207Y00000X
VA0101232142207Y00000X
FLME153243207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology