Individual
DR. AUSTIN DANIEL MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 975-1845
Mailing address
PO BOX 22067, LANSING, MI 48909-2067
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301506905
MI
Other
Enumeration date
04/15/2019
Last updated
09/23/2022
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