MEDICARE: MERRIE RAE MACDOWELL RM

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	176B00000X	Midwife	62	CO

General Provider Information

NPI Number	:	1891830667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERRIE RAE MACDOWELL RM

Provider Business Mailing Address
First Line	:	2211 N WEBER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6946
Country	:	US
Telephone Number	:	719-660-8721
Fax Number	:	719-638-0289

Provider Business Practice Location Address
First Line	:	2211 N WEBER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6946
Country	:	US
Telephone Number	:	719-660-8721
Fax Number	:	719-638-0289

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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