Dr Jacob N Maciejewski, MD | |
1601 Brigham Dr, Suite 200, Perrysburg, OH 43551-7114 | |
(419) 872-7700 | |
(419) 847-0196 |
Full Name | Dr Jacob N Maciejewski |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1601 Brigham Dr, Perrysburg, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437313244 | NPI | - | NPPES |
000000625705 | Other | OH | ANTHEM |
05815 | Other | PHC | |
2950230 | Medicaid | OH | |
9708368 | Other | OH | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 35.093510 (Ohio) | Primary |
Entity Name | Promedica Central Physicians |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043270150 PECOS PAC ID: 2365348190 Enrollment ID: O20031211000226 |
Mailing Address | Practice Location Address |
---|---|
Dr Jacob N Maciejewski, MD 1601 Brigham Dr, Suite 200, Perrysburg, OH 43551-7114 Ph: (419) 872-7700 | Dr Jacob N Maciejewski, MD 1601 Brigham Dr, Suite 200, Perrysburg, OH 43551-7114 Ph: (419) 872-7700 |
Jon R Dvorak, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1601 Brigham Dr, Suite 200, Perrysburg, OH 43551 Phone: 419-872-7700 Fax: 419-874-0196 | |
Carol A Kennedy, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1601 Brigham Dr, Suite 200, Perrysburg, OH 43551 Phone: 419-872-7700 Fax: 419-874-0196 | |
Vidya K Ramanathan, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1601 Brigham Dr, Suite 200, Perrysburg, OH 43551 Phone: 419-872-7700 Fax: 419-874-0196 | |
Dr. Jennifer K. Fallon-delucia, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 28555 Starbright Blvd Ste B, Perrysburg, OH 43551 Phone: 419-931-3030 Fax: 419-931-3046 | |
Kenneth A Turk, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1620 Brigham Dr Ste 240, Perrysburg, OH 43551 Phone: 419-872-7700 Fax: 419-874-0196 | |
Dr. Colleen J Olson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1601 Brigham Dr Ste 200, Perrysburg, OH 43551 Phone: 419-872-7700 Fax: 419-874-0196 |