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General NPI Number Information
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NPI Number | 1871974899
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Entity Type | Individual
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Provider Name | MICHAEL WILLIAM MAJETICH D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 11/23/2024
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Provider Practice Location Address
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Address Line | 510 5TH AVE STE 130
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City | CHARDON
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State | OH
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Zip | 44024-1076
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Country | US
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Telephone | 440-279-1500
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Fax | 440-279-1501
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Provider Business Mailing Address
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Address Line | 10775 LOCUST GROVE DR
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City | CHARDON
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State | OH
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Zip | 44024-8873
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Country | US
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Telephone | 440-313-8192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.013248
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License Number State | OH
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