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Individual

MARK D MACKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
6621 W MAPLE RD, W BLOOMFIELD, MI 48322-3004
(248) 661-4700
(248) 661-6210
Mailing address
4158 SOUTHMOOR LN, W BLOOMFIELD, MI 48323-3127
(248) 626-1874

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MM059872
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3410648-10
MI
Enumeration date
12/02/2005
Last updated
12/18/2009
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