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NPI Code Detail

MEDICARE: FOUR MAC INC

MEDICARE: FOUR MAC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1336091719
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOUR MAC INC
Provider Business Mailing Address
First Line : PO BOX 568
Second Line :
City : MUNCIE
State : IN
Zip : 47308-0568
Country : US
Telephone Number : 765-284-0493
Fax Number : 765-284-2434
Provider Business Practice Location Address
First Line : 1415 ROSS AVE
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-4306
Country : US
Telephone Number : 760-339-7100
Fax Number :
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : TIMOTHY P MCGRATH
Credential : M.D.
Telephone Number : 904-742-7286
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “FOUR MAC INC ” Practice Location

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