Healthcare Provider Details

I. General information

NPI: 1376639237
Provider Name (Legal Business Name): MARY CAROLYN DOWNING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/08/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 LEXINGTON AVE
SAVANNAH GA
31404-5502
US

IV. Provider business mailing address

1101 LEXINGTON AVE
SAVANNAH GA
31404-5502
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-7171
  • Fax: 912-350-3454
Mailing address:
  • Phone: 912-350-7171
  • Fax: 912-350-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number058410
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.204487
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: