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Fatmeh Mackie

NPI Registration Record

Provider / OrganizationNPIDate Certified
FATMEH MACKIE19226137932020-09-13
Entity TypeIndividual
Provider Name Fatmeh Mackie
Practice Office Address10037 BURLEY ST APT B3
DEARBORN, MI US
Practice Office Telephone7345567701
Mailing Address10037 BURLEY ST APT B3
DEARBORN, MI 481201671 US
Business Telephone7345567701
HPT Codes
CodeLicense NoState
374U00000X
251E00000X PRIMARY
OPI Codes
9390840 MEDICAID MI

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