Individual
JEREMY JAMES MACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2423 SCOTS PINE XING, DURHAM, NC 27713-6221
(321) 558-4576
Mailing address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 471-9466
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2015-02046
NC
Other
Enumeration date
05/18/2011
Last updated
01/25/2017
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