MEDICARE: ERIN DOWD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	LAT-2071	NC

General Provider Information

NPI Number	:	1164924429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN DOWD

Provider Business Mailing Address
First Line	:	8160 VETERANS PKWY APT 331
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-1943
Country	:	US
Telephone Number	:	252-367-6434
Fax Number	:

Provider Business Practice Location Address
First Line	:	6510 MCVEIGH DR BLDG 83
Second Line	:
City	:	FORT BENNING
State	:	GA
Zip	:	31905-6214
Country	:	US
Telephone Number	:	252-367-6434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2018
Last Update Date	:	03/02/2018

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