Individual
NATHAN RAYMOND MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
295 VARNUM AVE, LOWELL GENERAL HOSPITAL EMERGENCY DEPARTMENT, LOWELL, MA 01854-2134
(978) 937-6161
Mailing address
295 VARNUM AVE, LOWELL GENERAL HOSPITAL EMERGENCY DEPARTMENT, LOWELL, MA 01854-2134
(978) 937-6161
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MA155399
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2143577
—
MA
01
—
J42432
BLUE SHIELD
MA
Enumeration date
04/26/2006
Last updated
08/12/2009
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