Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2007-01639 | NC |
N | 111NI0900X | Internist | 2007-01639 | NC |
N | 208000000X | Pediatrician | 2007-01639 | NC |
Y | 2080P0203X | Pediatric Critical Care Doctor | 2007-01639 | NC |
NPI | 1013996362 |
---|---|
Provider Name | Daniel J Mackey |
First Address | Sylva, NC 28779-7700 |
Second Address | Sylva, NC 28779-7700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2006 |
Last Update Date | 09/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H14342 | (02) | NC |
H14342 | (02) | VA |