Provider Demographics
NPI:1982708244
Name:MCDONALD, VERONICA M (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:M
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4299 W FIVE OAKS DRIVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911
Mailing Address - Country:US
Mailing Address - Phone:517-272-5060
Mailing Address - Fax:517-272-5020
Practice Address - Street 1:4299 W FIVE OAKS DRIVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911
Practice Address - Country:US
Practice Address - Phone:517-272-5060
Practice Address - Fax:517-272-5020
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI55066837207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI55066837OtherBCBS MI
MI0400474OtherPHYSICIAN HEALTH PLAN
MI439818Medicaid
MI0400474OtherPHYSICIAN HEALTH PLAN
G12831Medicare UPIN