Individual
MATHEW WILLIAM MACZIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1601 CORNHUSKER DR, SOUTH SIOUX CITY, NE 68776-3924
(402) 494-8850
Mailing address
1601 CORNHUSKER DR, SOUTH SIOUX CITY, NE 68776-3924
(402) 494-8850
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13448
NE
183500000X
Pharmacist
21248
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13448
PHARMACIST
NE
01
—
21248
PHARMACIST
IA
Enumeration date
04/06/2018
Last updated
04/06/2018
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