Individual
DR. TIMOTHY DONALD MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.,F.C.C.P.
Contact information
Practice address
780 N GAVORD RD, STERLING, MI 48659-9703
(989) 654-2168
(989) 654-2825
Mailing address
780 N GAVORD RD, STERLING, MI 48659-9703
(989) 654-2168
(989) 654-2825
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
TM009037
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000781
MCLAREN HEALTH ADVANTAGE
MA
01
—
1007603
MCLAREN HEALTH PLAN
MI
01
—
110216075
RAIL ROAD MEDICARE
MI
01
—
115651012
BLUE CROSS BLUE SHIELD
MI
01
—
122278
PREFERRED CHOICE
MI
01
—
302002
CENTRAL HEALTH PLAN OF MI
MA
01
—
383563124
PPOM
MI
01
—
383563124101
COMMUNITY CHOICE OF MICH
MI
05
—
4261168
—
MI
01
—
4509887
AETNA
MI
Enumeration date
10/06/2005
Last updated
10/23/2020
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