Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD445241 | PA |
N | 111NI0900X | Internist | MD445241 | PA |
N | 207R00000X | Internist | MT194419 | PA |
N | 111NI0900X | Internist | MT194419 | PA |
Y | 207RH0002X | Hospice and Palliative Medicine | MD445241 | PA |
NPI | 1295969061 |
---|---|
Provider Name | Michael J Macauley |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 14/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1027328280001 | (05) | PA |