Provider Demographics
NPI:1932804721
Name:MCDONALD, MATHESON ANNE (MPAP, MSPH, PA-C)
Entity Type:Individual
Prefix:
First Name:MATHESON
Middle Name:ANNE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MPAP, MSPH, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6681 OLD WIRE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28351-9788
Mailing Address - Country:US
Mailing Address - Phone:910-280-6072
Mailing Address - Fax:
Practice Address - Street 1:925 S LONG DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4835
Practice Address - Country:US
Practice Address - Phone:910-417-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC1932804721208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program