Provider Demographics
NPI:1316190523
Name:MAJCHRZAK, DAVID T (MA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:MAJCHRZAK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 GREEN CT STE 185
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1595
Mailing Address - Country:US
Mailing Address - Phone:734-222-6046
Mailing Address - Fax:734-222-3639
Practice Address - Street 1:3520 GREEN CT STE 185
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-1595
Practice Address - Country:US
Practice Address - Phone:734-222-6046
Practice Address - Fax:734-222-3639
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013951103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist