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General NPI Number Information
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NPI Number | 1952325466
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Entity Type | Individual
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Provider Name | DAVID HASKINS MACRAE MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 610 PROVIDENCE PARK DR E STE 101
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City | MOBILE
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State | AL
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Zip | 36695
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Country | US
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Telephone | 251-378-3900
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Fax | 251-378-3902
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Provider Business Mailing Address
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Address Line | 610 PROVIDENCE PARK DR E STE 101
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City | MOBILE
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State | AL
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Zip | 36695-4618
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Country | US
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Telephone | 251-378-3900
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Fax | 251-378-3902
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD.11594
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 00011594
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License Number State | AL
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