MACMED LLC NPI 1417062613

NPI Information

NPI: 1417062613
Provider Name: MACMED LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
2927 DEMERE RD
ATTEN: DR ANDREW T MCRAE
ST SIMONS ISLAND, GA
ZIP 31522
Phone: (912) 638-1999
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MACMED LLC is a general practice in St Simons Island, GA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MACMED LLC NPI is 1417062613. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2927 DEMERE RD
ATTEN: DR ANDREW T MCRAE
ST SIMONS ISLAND, GA
ZIP 31522-620
Phone: (912) 638-1999

The provider's authorized official is Judy S Rivenbark .
The authorized official title is Owner and has the following contact phone number (850) 279-4917.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 8/29/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207Q00000X	Family Medicine	GA051731	GEORGIA	No
2	208M00000X	Hospitalist	GA11411	GEORGIA	No
3	208D00000X	General Practice	GA11411	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300034700A	MEDICAID	GEORGIA
2	GRP3484	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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