Provider Demographics
NPI:1073683710
Name:MACDUFF, MICHAEL A (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:MACDUFF
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 1:2215 G STREET
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3931
Mailing Address - Country:US
Mailing Address - Phone:661-324-1312
Mailing Address - Fax:661-324-0901
Practice Address - Street 1:2215 G STREET
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3931
Practice Address - Country:US
Practice Address - Phone:661-324-1312
Practice Address - Fax:661-324-0901
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG17033207N00000X, 207ND0900X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G170330Medicaid
A39977Medicare UPIN
CA00G170330Medicaid