Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 142001 | CA |
Y | 207X00000X | Orthopaedic Surgeon | MD21410 | ME |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 142001 | CA |
NPI | 1023463726 |
---|---|
Provider Name | Dr. Michael Allan Mackechnie |
First Address | Augusta, ME 04330-7997 |
Second Address | Augusta, ME 04330-7997 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2016 |
Last Update Date | 06/09/2017 |