Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 200961 | NC |
N | 208600000X | Surgeon | 200961 | NC |
Y | 208800000X | Urologist | 0101266587 | VA |
N | 208800000X | Urologist | 200961 | NC |
NPI | 1023428109 |
---|---|
Provider Name | Matthew Macey |
First Address | Richmond, VA 23235-1979 |
Second Address | Richmond, VA 23235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2014 |
Last Update Date | 28/10/2020 |