Provider Demographics
NPI:1649505496
Name:MACHAN, MAC LEE (MD)
Entity type:Individual
Prefix:DR
First Name:MAC
Middle Name:LEE
Last Name:MACHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6460 MEDICAL CENTER ST STE 350
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2423
Mailing Address - Country:US
Mailing Address - Phone:702-255-6647
Mailing Address - Fax:
Practice Address - Street 1:6460 MEDICAL CENTER ST STE 350
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2423
Practice Address - Country:US
Practice Address - Phone:702-255-6647
Practice Address - Fax:702-933-1444
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2014-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV15220207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery