Individual
DAVID MACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6900 E 10 MILE RD, CENTER LINE, MI 48015-1168
(586) 756-7777
Mailing address
6800 E 10 MILE RD, CENTER LINE, MI 48015-1167
(586) 619-9986
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101026137
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
03/21/2024
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