Healthcare Provider Details

I. General information

NPI: 1962472902
Provider Name (Legal Business Name): DOUGLAS J MACASKILL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 KERCHEVAL AVE.
GROSSE POINTE MI
48236
US

IV. Provider business mailing address

PO BOX 670660
DETROIT MI
48267-0660
US

V. Phone/Fax

Practice location:
  • Phone: 313-640-2300
  • Fax:
Mailing address:
  • Phone: 866-321-8433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number5101010166
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101010166
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: