Individual
DR. MICHAEL RICHARD MACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1948 1ST AVENUE NE, CEDAR RAPIDS, IA 52402-5321
(319) 364-0121
(319) 364-5684
Mailing address
1948 1ST AVE NE, CEDAR RAPIDS, IA 52402-5321
(319) 364-0121
(319) 364-5684
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
37225
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518186980
—
IA
01
—
72198
WELLMARK
IA
Enumeration date
04/24/2007
Last updated
11/06/2015
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