Provider Demographics
NPI:1699802868
Name:MACER, ANTOINETTE S
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:S
Last Name:MACER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 LENNOX ST APT D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4614
Mailing Address - Country:US
Mailing Address - Phone:443-857-2554
Mailing Address - Fax:
Practice Address - Street 1:755 LENNOX ST APT D
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-4614
Practice Address - Country:US
Practice Address - Phone:443-857-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide