Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 4301051724 | MI |
N | 207PE0004X | Emergency Medical Services | 051724 | MI |
Y | 207RH0002X | Hospice and Palliative Medicine | 4301051724 | MI |
NPI | 1154361137 |
---|---|
Provider Name | Cheryl F Macdonald |
First Address | Saint Joseph, MI 49085-3421 |
Second Address | Saint Joseph, MI 49085-3421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 29/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4730712 | (05) | MI |
4730730 | (05) | MI |
CM051724 | BC/BS (01) | MI |
D69497 | (02) | MI |