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NPI Code Detail

MEDICARE: DR. MAC LEE MACHAN M.D.

MEDICARE: DR. MAC LEE MACHAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ND0101XMOHS-Micrographic Surgery Physician15220NV

General Provider Information

NPI Number : 1649505496
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAC LEE MACHAN M.D.
Provider Business Mailing Address
First Line : 6460 MEDICAL CENTER ST STE 350
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-2423
Country : US
Telephone Number : 702-255-6647
Fax Number :
Provider Business Practice Location Address
First Line : 6460 MEDICAL CENTER ST STE 350
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-2423
Country : US
Telephone Number : 702-255-6647
Fax Number : 702-933-1444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2009
Last Update Date : 07/31/2014

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Directions to “ DR. MAC LEE MACHAN M.D.” Practice Location

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