Individual provider · Type 1 NPI
Dave Mack
Military Health Care Provider · Madison, WI
NPI number
1376648154
Active
Practice location
1514 Drake St.
Madison, WI 53711
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Health Care Provider Primary | 171000000X | NA (WI) |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
About NPI 1376648154
Dave Mack's National Provider Identifier is 1376648154, issued on Sep 14, 2006. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Madison, WI. The record was last updated on Jul 8, 2007.