Provider Demographics
NPI:1952594079
Name:GALANG-QAHWASH, MARIA DONNA (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DONNA
Last Name:GALANG-QAHWASH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:M. DONNA
Other - Middle Name:
Other - Last Name:QAHWASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:802 W KING ST STE A
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2100
Mailing Address - Country:US
Mailing Address - Phone:989-288-3300
Mailing Address - Fax:989-720-1091
Practice Address - Street 1:802 W KING ST STE A
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2100
Practice Address - Country:US
Practice Address - Phone:989-288-3300
Practice Address - Fax:989-720-1091
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017491207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1952594079Medicaid