Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301116418 | MI |
N | 111NI0900X | Internist | 4301116418 | MI |
N | 207RH0000X | Hematologist | 036-109957 | IL |
Y | 207RH0000X | Hematologist | 4301116418 | MI |
N | 207RH0003X | Hematology & Oncology | 036-109957 | IL |
NPI | 1235334137 |
---|---|
Provider Name | John Joseph Maciejewski |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 19/02/2020 |