Basic Information
| Provider Information | |||||||||
| NPI: | 1376625061 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCDOWELL | ||||||||
| FirstName: | THOMAS | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 CAREW ST | ||||||||
| Address2: | STE 300 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137812211 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 CAREW ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137812211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 10/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1143 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.