Individual
MICHAEL MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HAD/HIS
Contact information
Practice address
5553 LILAC PL NE, RIO RANCHO, NM 87144-5804
(505) 235-0110
(505) 771-2353
Mailing address
5553 LILAC PL NE, RIO RANCHO, NM 87144-5804
(505) 771-2353
(505) 771-2353
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HAD0898
NM
261QH0700X
Hearing and Speech Clinic/Center
HAD0898
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0898
NEW MEXICO REGULATION AND LICENSING DEPARTMENT
NM
01
—
19-00152716
MIRACLE EAR
NM
01
—
HAD0898
NEW MEXICO REGULATION AND LICENSING DEPARTMENT
NM
Enumeration date
04/10/2019
Last updated
01/03/2022
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