Provider Demographics
NPI:1073671418
Name:OSYPIUK, MACIEJ (MD)
Entity Type:Individual
Prefix:DR
First Name:MACIEJ
Middle Name:
Last Name:OSYPIUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MARTHAS WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1294
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:91 WASHINGTON ST FL 2
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2429
Practice Address - Country:US
Practice Address - Phone:508-824-4874
Practice Address - Fax:508-823-2990
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213323207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD84330OtherAETNA
MAJ26149OtherBLUE CROSS, BLUE SHIELD
MA2008181Medicaid
MAP00119734OtherRAILROAD MEDICAL CARE
MAJ26149OtherBLUE CROSS, BLUE SHIELD
MA2008181Medicaid