Provider Demographics
NPI:1699818500
Name:MACKLIN, MICHAEL NEAL (MD,)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NEAL
Last Name:MACKLIN
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9121
Mailing Address - Country:US
Mailing Address - Phone:919-968-0672
Mailing Address - Fax:
Practice Address - Street 1:617 BAYBERRY DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9121
Practice Address - Country:US
Practice Address - Phone:919-968-0672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC237312084P0800X
NC237212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC85275Medicare UPIN