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Individual

DIANE MARIE MACDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
401 W GREENLAWN AVE, LANSING, MI 48910-2819
(517) 975-9500
(517) 975-9511
Mailing address
804 SERVICE RD, A201, EAST LANSING, MI 48824-7015
(517) 884-2976
(517) 432-3928

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301053125
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01004511
HEALTHPLUS
MI
01
1014282
MCLAREN HEALTH PLAN
MI
01
1102911631
BCBSM
MI
05
1447297742
MI
01
200000005798
PHP COMMERCIAL
MI
05
4711403-10
MI
05
4711898-10
MI
05
4711913-10
MI
Enumeration date
06/02/2006
Last updated
06/08/2016
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