MEDICARE: MICHAEL DOWNING

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	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT118	OTHER	ME	LICENSE #

General Provider Information

NPI Number	:	1124135777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DOWNING

Provider Business Mailing Address
First Line	:	45 VALLEY VIEW DR
Second Line	:
City	:	GORHAM
State	:	ME
Zip	:	04038-2543
Country	:	US
Telephone Number	:	207-839-6864
Fax Number	:

Provider Business Practice Location Address
First Line	:	584 ROOSEVELT TRL
Second Line	:
City	:	WINDHAM
State	:	ME
Zip	:	04062-4904
Country	:	US
Telephone Number	:	207-893-2490
Fax Number	:

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/08/2007

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Directions to “ MICHAEL DOWNING ” Practice Location

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