Provider Demographics
NPI:1740221936
Name:MACAL, OSCAR ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:ENRIQUE
Last Name:MACAL
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 1:300 HEALTH PARK DR STE 302
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1293
Mailing Address - Country:US
Mailing Address - Phone:989-723-5540
Mailing Address - Fax:
Practice Address - Street 1:300 HEALTH PARK DRIVE
Practice Address - Street 2:SUITE 302
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1292
Practice Address - Country:US
Practice Address - Phone:989-723-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301049566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5487268OtherAETNA
MIP47759OtherBCN
MI0400026OtherPHP
MI2577942Medicaid
MI1107800272OtherBC/BS
MIP47759OtherBCN
MI1107800272OtherBC/BS