Individual
MICHAEL DEAN MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4480 UTICA RIDGE RD, BETTENDORF, IA 52722-1644
(563) 742-4850
Mailing address
4578 ASHTON CIR, CRESTVIEW, FL 32536-2258
(515) 290-2100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3906
IA
207P00000X
Emergency Medicine Physician
Primary
OS12342
FL
Other
Enumeration date
02/05/2008
Last updated
01/21/2016
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