Individual
MICHAEL JOSEPH MACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8250
Mailing address
164 N BROADWAY, GREEN BAY, WI 54303-2728
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
65029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811212764
—
WI
Enumeration date
04/05/2010
Last updated
05/10/2017
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