Provider Demographics
NPI:1871974899
Name:MAJETICH, MICHAEL WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:MAJETICH
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:10775 LOCUST GROVE DR
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-8873
Mailing Address - Country:US
Mailing Address - Phone:440-313-8192
Mailing Address - Fax:
Practice Address - Street 1:510 5TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1076
Practice Address - Country:US
Practice Address - Phone:440-279-1500
Practice Address - Fax:440-279-1501
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.013248207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine