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General NPI Number Information
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NPI Number | 1992777296
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Entity Type | Individual
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Provider Name | RICHARD WAYNE MACAULEY MD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 565 PROGRESS ST
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City | WEST BRANCH
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State | MI
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Zip | 48661-8601
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Country | US
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Telephone | 877-595-1090
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Fax | 989-345-3163
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Provider Business Mailing Address
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Address Line | PO BOX 932879
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City | CLEVELAND
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State | OH
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Zip | 44193-0025
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Country | US
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Telephone | 877-595-1090
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Fax | 989-345-3163
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301042308
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License Number State | MI
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