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NPI Code Detail

MEDICARE: MICHAEL L MAHACEK MD

MEDICARE: MICHAEL L MAHACEK MD
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
12085R0001XRadiation Oncology Physician053126MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2920001168OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922021484
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL L MAHACEK MD
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number : 616-391-1830
Fax Number : 616-391-1286
Provider Business Practice Location Address
First Line : 100 MICHIGAN ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number : 616-391-1830
Fax Number : 616-391-1286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 12/09/2025

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