Individual
DR. SUSAN MARIE MACKEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1050 BOYLES ST, MAIL STOP 5, BLDG 539, ROOM 121A, FREDERICK, MD 21702-9242
(301) 228-4200
(301) 846-7117
Mailing address
1050 BOYLES ST, MAIL STOP 5, BLDG 539, ROOM 121A, FREDERICK, MD 21702-9242
(301) 228-4200
(301) 846-7117
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
D0037718
MD
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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