Individual
MARY A MACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
905 UNION ST STE 9, BANGOR, ME 04401-3039
(207) 973-8998
(207) 973-4294
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
(207) 973-5000
(207) 973-5042
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
014605
ME
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD14605
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08755581
—
MS
01
—
C03168
MEDICARE GROUP
—
01
—
DB9706
RAILROAD MEDICARE GROUP
—
Enumeration date
08/09/2006
Last updated
10/22/2020
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