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Individual

MARCUS JOHN DILL-MACKY

Active
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Individual

MARCUS JOHN DILL-MACKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36072
AZ
2085U0001X
Diagnostic Ultrasound Physician
36072
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005472
GROUP MEDICAID ID
AZ
05
178062
AZ
01
1841261989
GROUP NPI
AZ
01
1992842603
PHYSICIAN INDIVIDUAL NPI NUMBER
AZ
01
CS7943
GROUP MEDICARE RAILROAD ID & PTAN
AZ
01
P00406247
MEDICARE RAILROAD
AZ
01
ZWCBBM
GROUP MEDICARE ID
AZ
Enumeration date
01/31/2007
Last updated
02/27/2013
Update your record

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