Individual
STANISLAW P DAJCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 RALSTON AVE, SUITE 102, DEFIANCE, OH 43512-5311
(419) 783-6996
(419) 782-8062
Mailing address
1250 RALSTON AVE, SUITE 102, DEFIANCE, OH 43512-5311
(419) 783-6996
(419) 782-8062
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35085114
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362612
ANTHEM
OH
01
—
04648
PHC
OH
01
—
17-98831
UHC
OH
05
—
2542001
—
OH
01
—
5598615
AETNA
—
01
—
P00192953
RRMC
OH
01
—
PO0192953
RRMC
OH
Enumeration date
08/30/2005
Last updated
04/30/2012
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