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Physician Compare National (NPI:1346448453)

HEALTHCARE PROVIDER: DEXTER NOLAND MCDONALD RPT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1346448453
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4486831203
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20110603000428
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MCDONALD
Individual professional last name
Provider First Name DEXTER
Individual professional first name
Provider Middle Name N
Individual professional middle name
Provider Name Suffix Text SR.
The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1984
Individual professional's medical school graduation year
Primary Specialty PHYSICAL THERAPY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 502 5TH AVE DR E
Group Practice or individual's line 1 address
City BRADENTON
Group Practice or individual's city
State FL
Group Practice or individual's state
Zip Code 342082006
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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