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General NPI Number Information
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NPI Number | 1811907199
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Entity Type | Individual
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Provider Name | MARY A MACY M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 905 UNION ST STE 9
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City | BANGOR
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State | ME
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Zip | 04401-3039
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Country | US
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Telephone | 207-973-8998
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Fax | 207-973-4294
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Provider Business Mailing Address
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Address Line | 43 WHITING HILL RD STE 300
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City | BREWER
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State | ME
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Zip | 04412-1006
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Country | US
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Telephone | 207-973-5000
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Fax | 207-973-5042
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 014605
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD14605
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License Number State | ME
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