Provider Demographics
NPI:1235104340
Name:DOWD, MARY K (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:DOWD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:M
Other - Middle Name:KATHERINE
Other - Last Name:DOWD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 E NEW YORK AVE
Mailing Address - Street 2:MOB 2ND FLOOR
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2340
Mailing Address - Country:US
Mailing Address - Phone:609-365-3100
Mailing Address - Fax:609-365-3165
Practice Address - Street 1:1 E NEW YORK AVE
Practice Address - Street 2:MOB 2ND FLOOR
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2340
Practice Address - Country:US
Practice Address - Phone:609-365-3100
Practice Address - Fax:609-365-3165
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18566207RC0000X
PAMD027955E207RC0000X
NJ25MA04583300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0149900OtherAMERIGROUP
NJ0149900Medicaid
NJ223457816OtherHORIZON BLUE SHIELD
NJ0270372000OtherAMERIHEALTH
NJ043831OtherKEYSTONE HEALTH PLAN EAST
NJ1086125OtherHORIZON MERCY HEALTH PLAN
NJ060042448OtherRAILROAD MEDICARE
NJNJ0015032OtherTRICARE HEALTHNET FEDERAL
NJ060042448OtherAETNA US HEALTHCARE
NJP412960OtherOXFORD
PA043831OtherPENNSYLVANIA BLUE SHIELD
NJ223457816OtherUNITED HEALTHCARE
NJ223457816OtherAETNA
NJ223457816001OtherCIGNA
NJ73170OtherLOCAL 825 OPERATING ENGIN
NJF15687OtherHEALTHNET
NJP412960OtherOXFORD
NJE13097Medicare UPIN
NJ0149900Medicaid