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Individual

MACDONALD DICK II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301039061
MI
2080P0202X
Pediatric Cardiology Physician
Primary
4301039061
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1280419
MI
Enumeration date
08/08/2006
Last updated
09/30/2019
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