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NPI Code Detail

MEDICARE: MRS. MARY C DONLEY MD

MEDICARE: MRS. MARY C DONLEY MD
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
1174400000XSpecialist01034109IN
2207R00000XInternal Medicine Physician01034109IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669467932
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY C DONLEY MD
Provider Business Mailing Address
First Line : 7916 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4140
Country : US
Telephone Number : 260-434-6377
Fax Number : 260-434-6389
Provider Business Practice Location Address
First Line : 303 S MAIN ST
Second Line :
City : BLUFFTON
State : IN
Zip : 46714-2503
Country : US
Telephone Number : 260-919-3567
Fax Number : 260-919-3558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 09/15/2020

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Directions to “ MRS. MARY C DONLEY MD” Practice Location

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