Individual
DR. CIELO MARIE MACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 N MAIN ST, MOUNT VERNON, MO 65712-1004
(417) 461-5215
(417) 461-5729
Mailing address
6250 CREEKSEDGE DR, OZARK, MO 65721-6613
(417) 631-8605
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
37314
AZ
207RP1001X
Pulmonary Disease Physician
015849
ME
207RP1001X
Pulmonary Disease Physician
Primary
2006007765
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301960099
—
ME
Enumeration date
06/02/2006
Last updated
11/03/2013
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