MEDICARE: MAREN KAY MACDONALD PA-C

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	207Q00000X	Family Medicine Physician	1470	CO

General Provider Information

NPI Number	:	1962664649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAREN KAY MACDONALD PA-C

Provider Business Mailing Address
First Line	:	595 CHAPEL HILLS DR STE 303A
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1022
Country	:	US
Telephone Number	:	719-434-8810
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 CHAPEL HILLS DR STE 303A
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1022
Country	:	US
Telephone Number	:	719-434-8810
Fax Number	:

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	01/19/2026

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