Individual
DR. DIANE M MACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1020 HIGH RD, BREMEN, IN 46506-0008
(574) 546-2211
Mailing address
5620 SOUTHWYCK BLVD, TOLEDO, OH 43614-1501
(800) 288-8325
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
02000864A
IN
Other
Enumeration date
11/16/2005
Last updated
01/06/2010
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