MEDICARE: MMD SERVICES, PC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1164061099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MMD SERVICES, PC

Provider Business Mailing Address
First Line	:	3107 W. COLORADO AVE
Second Line	:	#275
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-2040
Country	:	US
Telephone Number	:	719-249-0217
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 W COLORADO AVE STE 103
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-3863
Country	:	US
Telephone Number	:	719-249-0217
Fax Number	:	719-982-0035

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. MARGARET ETHEL MACDONALD
Credential	:	MD
Telephone Number	:	719-249-0217

Provider Enumeration Date	:	12/23/2019
Last Update Date	:	03/24/2021

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