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General NPI Number Information
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NPI Number | 1962883983
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Entity Type | Individual
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Provider Name | SIMONE ADDISON MAJETICH D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 27100 CHARDON RD MEDICAL EDUCATION, UNIVERISTY HOSPITALS
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-1116
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Country | US
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Telephone | 440-585-6553
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Fax | 440-585-6141
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Provider Business Mailing Address
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Address Line | 7590 AUBURN ROAD, SUITE 014 ATTN: MED STAFF
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City | CONCORD TWP
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State | OH
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Zip | 44077-9176
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Country | US
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Telephone | 440-354-1899
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Fax | 440-354-1845
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 58.006019
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License Number State | OH
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