Individual
MARIO ALEJANDRO MACIAS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3870 COLUMBIA AVE, OSAGE BEACH, MO 65065-8689
(877) 406-2662
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(877) 406-2662
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2021012099
MO
207V00000X
Obstetrics & Gynecology Physician
OS017813
PA
Other
Enumeration date
05/03/2012
Last updated
05/16/2022
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