Organization
MACIEY J DRUZDZEL MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MACIEY J DRUZDZEL MD (PRESIDENT)
15412479499
Entity
Organization
Contact information
Practice address
29593 ELLENSBURG AVE., GOLD BEACH, OR 97444-1650
(154) 124-7949
(154) 124-7967
Mailing address
PO BOX 1650, 29593 ELLENSBURG, GOLD BEACH, OR 97444-1650
(154) 124-7949
(154) 124-7967
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD18563
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121280
—
OR
01
—
R104978
MEDICARE
OR
Enumeration date
07/20/2012
Last updated
07/20/2012
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