Individual
MAHENDER MACHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 E MICHIGAN AVE, SUITE 301, JACKSON, MI 49201-1847
(517) 817-7605
(517) 817-7606
Mailing address
PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-0002
(517) 817-7605
(517) 817-7606
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
4301064881
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD050898L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015061690004
—
PA
Enumeration date
10/13/2005
Last updated
03/01/2021
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