Individual
MIRIAM D MCDONELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1730 E 12TH ST, THE DALLES, OR 97058
(541) 296-9151
(541) 296-9156
Mailing address
1730 E 12TH ST, PO BOX 1520, THE DALLES, OR 97058
(541) 296-9151
(541) 296-9156
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MD18477
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276259
—
OR
Enumeration date
07/20/2007
Last updated
02/02/2009
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