Healthcare Provider Details

I. General information

NPI: 1033193750
Provider Name (Legal Business Name): JAMES M MACEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PAYSON RD SUITE 3
FOXBORO MA
02035-1309
US

IV. Provider business mailing address

15 PAYSON RD SUITE 3
FOXBORO MA
02035-1309
US

V. Phone/Fax

Practice location:
  • Phone: 508-772-1438
  • Fax:
Mailing address:
  • Phone: 508-772-1438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD08555
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: