Individual
COLLEEN H. MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3626
(706) 721-2643
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-6410
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
056153
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
386163290A
—
GA
05
—
G56153
—
SC
Enumeration date
08/30/2006
Last updated
11/30/2012
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