Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35087599 | OH |
N | 208600000X | Surgeon | 35087599 | OH |
Y | 2086X0206X | Surgical Oncologist | D0066058 | MD |
NPI | 1336244839 |
---|---|
Provider Name | Richard A Mackey |
First Address | Towson, MD 21204-7736 |
Second Address | Towson, MD 21204-7736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 11/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2662819 | (05) | OH |
I60608 | (02) | OH |