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NPI Code Detail

MEDICARE: DR. HOMEIRA MCDONALD MD

MEDICARE: DR. HOMEIRA MCDONALD 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician4301041972MI

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 : 1720060635
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOMEIRA MCDONALD MD
Provider Business Mailing Address
First Line : 5620 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1501
Country : US
Telephone Number : 800-288-8325
Fax Number :
Provider Business Practice Location Address
First Line : 2601 ELECTRIC AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060-6587
Country : US
Telephone Number : 810-985-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 11/01/2007

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