1033463591 NPI number — DONALD A MAJERCIK, MD, FACS, PC

Table of content: DR. KRISTEN RAWLETT PHD, FNP-BC, FAANP, (NPI 1285623751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033463591 NPI number — DONALD A MAJERCIK, MD, FACS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DONALD A MAJERCIK, MD, FACS, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033463591
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18 PEARL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ESSEX JUNCTION
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05452-3605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-879-6681
Provider Business Mailing Address Fax Number:
802-879-0538

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 PEARL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESSEX JUNCTION
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05452-3605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-879-6681
Provider Business Practice Location Address Fax Number:
802-879-0538
Provider Enumeration Date:
11/06/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MAJERCIK
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MD, FACS, PC
Authorized Official Telephone Number:
802-879-6681

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  042-0004367 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0005357 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




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