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Individual

DR. RICHARD WAYNE MACAULEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
565 PROGRESS ST, WEST BRANCH, MI 48661-8601
(877) 595-1090
(989) 345-3163
Mailing address
PO BOX 932879, CLEVELAND, OH 44193-0025
(877) 595-1090
(989) 345-3163

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301042308
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
930117513
RAILROAD MEDICARE
MI
01
OF51015
BLUE CROSS
MI
Enumeration date
02/02/2006
Last updated
12/17/2015
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