Provider Demographics
NPI:1235652363
Name:MACRAE, CASSIE BRIEANA (MD)
Entity type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:BRIEANA
Last Name:MACRAE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 CAMINO DE SALUD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-4519
Mailing Address - Country:US
Mailing Address - Phone:505-272-3053
Mailing Address - Fax:
Practice Address - Street 1:1101 CAMINO DE SALUD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-4519
Practice Address - Country:US
Practice Address - Phone:505-272-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
MA271288390200000X
NMMD2025-0503207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program