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General NPI Number Information
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NPI Number | 1699108951
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Entity Type | Organization
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Legal Business Name | MAC PHYSICIANS LLC
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 5936 LIMESTONE RD STE 301B
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City | HOCKESSIN
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State | DE
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Zip | 19707-8932
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Country | US
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Telephone | 302-235-8808
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Fax | 302-235-8808
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Provider Business Mailing Address
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Address Line | 1205 KINTERRA CT
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City | WEST CHESTER
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State | PA
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Zip | 19382-6976
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Country | US
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Telephone | 302-235-8808
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Fax | 302-351-8769
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Authorized Official
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Title or Position | PRESIDENT
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Name | VINCENT E SCHALLER
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Credential | MD
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Telephone | 302-235-8808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C10004737
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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