Provider Demographics
NPI:1316066806
Name:MACNOWSKI, JOHN III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:MACNOWSKI
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 27127
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-7127
Mailing Address - Country:US
Mailing Address - Phone:231-346-6800
Mailing Address - Fax:231-346-6017
Practice Address - Street 1:1105 SIXTH ST
Practice Address - Street 2:TRAVERSE CITY
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2345
Practice Address - Country:US
Practice Address - Phone:231-935-5000
Practice Address - Fax:231-346-6017
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301088170207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine