Organization Name: | MARCOS MACHADO MD, PC |
NPI Number: | 1982990693 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARCOS MACHADO (PRESIDENT/PHYSICIAN) |
Mailing Address: | 10019 Miller Rd Swartz Creek |
State: | MI US |
Postal Code: | 484738590 |
Phone Number: | 8106354476 |
Fax Number: | 8106354357 |
NPI Enumeration Date: | 06/21/2011 |
NPI Last Update Date: | 06/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 4301087655 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |