Individual
JOHN ANTHONY MACOVIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
80 GRESHAM LN, ATHERTON, CA 94027-3918
(619) 929-5336
Mailing address
80 GRESHAM LN, ATHERTON, CA 94027-3918
(619) 929-5336
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G49789
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G49789
CA
Other
Enumeration date
04/14/2007
Last updated
06/30/2016
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