Provider Demographics
NPI:1023463726
Name:MACKECHNIE, MICHAEL ALLAN (MD, CM, FAAOS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLAN
Last Name:MACKECHNIE
Suffix:
Gender:M
Credentials:MD, CM, FAAOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7997
Mailing Address - Country:US
Mailing Address - Phone:207-621-8700
Mailing Address - Fax:207-621-8745
Practice Address - Street 1:2150 SE SALERNO RD STE 110
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6572
Practice Address - Country:US
Practice Address - Phone:772-781-2735
Practice Address - Fax:772-781-2739
Is Sole Proprietor?:No
Enumeration Date:2016-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146666207XX0005X
CA142001207XX0005X
MEMD21410207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine