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NPI Code Detail

MEDICARE: MARK D MCGREGOR PA

MEDICARE:   MARK D MCGREGOR  PA
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
1363A00000XPhysician Assistant5601001613MI

General Provider Information

NPI Number : 1932177524
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK D MCGREGOR PA
Provider Business Mailing Address
First Line : 3621 S STATE ST
Second Line : 700 KMS PLACE
City : ANN ARBOR
State : MI
Zip : 48108
Country : US
Telephone Number : 734-936-2047
Fax Number :
Provider Business Practice Location Address
First Line : 1500 EAST MEDICAL CENTER DR
Second Line : B1 FLOOR UNIVERSITY HOSPITAL RECP C
City : ANN ARBOR
State : MI
Zip : 48109-5030
Country : US
Telephone Number : 734-936-4566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 05/01/2013

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Directions to “ MARK D MCGREGOR PA” Practice Location

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