Individual
DR. NANCY M. MACKOWSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4201 LAKE BOONE TRL, SUITE 104, RALEIGH, NC 27607-7512
(919) 944-0195
(919) 944-0085
Mailing address
4505 FAIR MEADOWS LN STE 207, RALEIGH, NC 27607-6449
(919) 787-7600
(919) 787-7603
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1571
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0936C
BCBS PROV #
NC
Enumeration date
11/07/2005
Last updated
05/04/2022
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