Provider Demographics
NPI:1235299702
Name:MCKENZIE, DEANNE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEANNE
Middle Name:MICHELLE
Last Name:MCKENZIE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1400 FOREST GLEN RD
Mailing Address - Street 2:SUITE 525
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1459
Mailing Address - Country:US
Mailing Address - Phone:301-593-8101
Mailing Address - Fax:301-593-1537
Practice Address - Street 1:1400 FOREST GLEN RD
Practice Address - Street 2:SUITE 525
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1459
Practice Address - Country:US
Practice Address - Phone:301-593-8101
Practice Address - Fax:301-593-1537
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-10-26
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Provider Licenses
StateLicense IDTaxonomies
MDD0056868207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H09563Medicare UPIN