Healthcare Provider Details

I. General information

NPI: 1003228974
Provider Name (Legal Business Name): MARGARET MCDONALD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5909 ILLINOIS RD
FORT WAYNE IN
46804-1159
US

IV. Provider business mailing address

1509 WHITE CORAL CT
FORT WAYNE IN
46814-8601
US

V. Phone/Fax

Practice location:
  • Phone: 260-434-3910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number26020887A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: