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General NPI Number Information
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NPI Number | 1932389244
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Entity Type | Organization
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Legal Business Name | DONALD D MCGOWAN, DPM
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 3015 MISHAWAKA AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-2347
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Country | US
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Telephone | 574-288-8200
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Fax | 574-288-8226
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Provider Business Mailing Address
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Address Line | 3015 MISHAWAKA AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-2347
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Country | US
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Telephone | 574-288-8200
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Fax | 574-288-8226
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Authorized Official
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Title or Position | OWNER
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Name | DONALD D MCGOWAN
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Credential |
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Telephone | 574-288-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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