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General NPI Number Information
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NPI Number | 1922503556
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Entity Type | Individual
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Provider Name | ROBERT JAMES MACIELAK MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 400 ALTAIR PKWY STE 4200
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City | WESTERVILLE
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State | OH
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Zip | 43082-7654
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Country | US
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Telephone | 614-366-3687
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Fax | 614-293-6176
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Provider Business Mailing Address
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Address Line | 700 ACKERMAN RD STE 2120
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City | COLUMBUS
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State | OH
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Zip | 43202-1559
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Country | US
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Telephone | 614-366-3687
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Fax | 614-293-6176
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 65886
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 57.254037
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License Number State | OH
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