Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 20227 | WV |
N | 207X00000X | Orthopaedic Surgeon | 35.078449 | OH |
N | 207X00000X | Orthopaedic Surgeon | 78449 | OH |
NPI | 1023004082 |
---|---|
Provider Name | John Alexander Michalski |
First Address | Martins Ferry, OH 43935-1648 |
Second Address | Glen Dale, WV 26038-1660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 13/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18032630000 | (05) | WV |
2194629 | (05) | OH |
C33869 | (02) | OH |