Individual
ENIKI A MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1240 JESSE JEWELL PKWY SE, SUITE 500, GAINESVILLE, GA 30501-3862
(770) 536-9864
Mailing address
1240 JESSE JEWELL PKWY SE, SUITE 500, GAINESVILLE, GA 30501-3862
(770) 536-9864
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
064410
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12099189
CAQH
—
Enumeration date
04/23/2007
Last updated
09/14/2020
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