| David R Macrae, Ph.d., P.c. | |
|
2025 E Beltline Ave Se Ste 104 Grand Rapids MI 49546-7673 | |
| (616) 957-3168 | |
| (616) 957-4033 |
| Full Name | David R Macrae, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 2025 E Beltline Ave Se Ste 104, Grand Rapids, Michigan |
| Authorized Official Name and Position | David R Macrae (OWNER) |
| Authorized Official Contact | 6169573168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David R Macrae, Ph.d., P.c. 2025 E Beltline Ave Se Ste 104 Grand Rapids MI 49546-7673 Ph: (616) 957-3168 | David R Macrae, Ph.d., P.c. 2025 E Beltline Ave Se Ste 104 Grand Rapids MI 49546-7673 Ph: (616) 957-3168 |
| NPI Number | 1154507325 |
|---|---|
| Provider Enumeration Date | 01/17/2008 |
| Last Update Date | 01/17/2008 |
| Medicare PECOS PAC ID | 3870650617 |
|---|---|
| Medicare Enrollment ID | O20090324000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154507325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 002310 (Michigan) | Primary |
| Provider Name | David Robert Macrae |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942426929 PECOS PAC ID: 5890852636 Enrollment ID: I20090324000229 |
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