Individual
MICHAEL JOHN MACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000694
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017406
DORAL
PA
05
—
1804008
—
PA
01
—
199862
BLUECROSSBLUESHIELD
PA
01
—
49912
DAVIS
PA
01
—
918348
EYEMED
PA
Enumeration date
01/16/2007
Last updated
11/27/2023
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