Basic Information
Provider Information
NPI: 1508857517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MACDONALD
FirstName: NANCY
MiddleName: LOWE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: JARRETT WHITE ROAD
Address2: TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS
City: TRIPLER AMC
State: HI
PostalCode: 968595001
CountryCode: US
TelephoneNumber: 8084332460
FaxNumber: 8084331558
Practice Location
Address1: JARRETT WHITE ROAD
Address2: TRIPLER ARMY MEDICAL CENTER
City: TRIPLER AMC
State: HI
PostalCode: 968595001
CountryCode: US
TelephoneNumber: 8084332460
FaxNumber: 8084331558
Other Information
ProviderEnumerationDate: 10/31/2005
LastUpdateDate: 08/15/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X169297-1205UTY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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