Provider Demographics
NPI:1932272879
Name:MCDOWELL, MICHAEL (LMBT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SCOTCH BONNET WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-2562
Mailing Address - Country:US
Mailing Address - Phone:910-352-6412
Mailing Address - Fax:
Practice Address - Street 1:204 SCOTCH BONNET WAY
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-2562
Practice Address - Country:US
Practice Address - Phone:910-352-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5834225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist