Individual
MICHAEL J MACDOUGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8262 ATLEE RD, SUITE 205, MECHANICSVILLE, VA 23116-1816
(804) 559-0194
(804) 559-0198
Mailing address
8262 ATLEE RD, SUITE 205, MECHANICSVILLE, VA 23116-1816
(804) 559-0194
(804) 559-0198
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101057303
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020038885
RAILROAD MEDICARE ID
VA
01
—
C06115
GROUP PTAN
VA
Enumeration date
10/27/2006
Last updated
08/04/2009
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