| Maciey J Druzdzel Md Pc | |
|
29593 Ellensburg Ave. Gold Beach OR 97444-1650 | |
| (154) 124-7949 | |
| (154) 124-7967 |
| Full Name | Maciey J Druzdzel Md Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 29593 Ellensburg Ave., Gold Beach, Oregon |
| Authorized Official Name and Position | Maciey J Druzdzel (PRESIDENT) |
| Authorized Official Contact | 15412479499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maciey J Druzdzel Md Pc Po Box 1650 29593 Ellensburg Gold Beach OR 97444-1650 Ph: (154) 124-7949 | Maciey J Druzdzel Md Pc 29593 Ellensburg Ave. Gold Beach OR 97444-1650 Ph: (154) 124-7949 |
| NPI Number | 1811242308 |
|---|---|
| Provider Enumeration Date | 07/20/2012 |
| Last Update Date | 07/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811242308 | NPI | - | NPPES |
| 121280 | Medicaid | OR | |
| R104978 | Other | OR | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD18563 (Oregon) | Primary |
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