Mac, Ivan

Mac, Ivan is an individual health care provider with primary practice located at 630 Comfort Ln , Monroe NC 28112-6199. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mac, Ivan can be contacted via phone (704) 289-5455.

Contact Information

Primary practice address
630 Comfort Ln Monroe NC 28112-6199
Phone: (704) 289-5455
Fax: (704) 291-2207
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 200401094 North Carolina

Profile Details

NPI number 1689654592
LBN Legal business name Mac, Ivan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Jul 7th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689654592 NPPES
North Carolina MEDICAID 89138MJ

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