Individual
DR. JACOB N MACIEJEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1601 BRIGHAM DR, SUITE 200, PERRYSBURG, OH 43551-7114
(419) 872-7700
(419) 847-0196
Mailing address
1601 BRIGHAM DR, SUITE 200, PERRYSBURG, OH 43551-7114
(419) 872-7700
(419) 847-0196
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.093510
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000625705
ANTHEM
OH
01
—
05815
PHC
—
05
—
2950230
—
OH
01
—
9708368
AETNA
OH
Enumeration date
07/11/2008
Last updated
11/03/2023
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