Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G17033 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | G17033 | CA |
N | 207ND0900X | Dermatopathologist | G17033 | CA |
NPI | 1073683710 |
---|---|
Provider Name | Mr. Michael A Macduff |
First Address | Bakersfield, CA 93301-3931 |
Second Address | Bakersfield, CA 93301-3931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 13/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G170330 | (05) | CA |
A39977 | (02) |