Provider Demographics
NPI:1619178837
Name:MARIA JAMIOLKOWSKI DO INC
Entity Type:Organization
Organization Name:MARIA JAMIOLKOWSKI DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAMIOLKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:740-450-4271
Mailing Address - Street 1:945 BETHESDA DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-0801
Mailing Address - Country:US
Mailing Address - Phone:740-450-4271
Mailing Address - Fax:740-450-4286
Practice Address - Street 1:945 BETHESDA DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0801
Practice Address - Country:US
Practice Address - Phone:740-450-4271
Practice Address - Fax:740-450-4286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007-115J208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2127200Medicaid
OH1154316909OtherNPI NUMBER
OHH08753Medicare UPIN
OH2127200Medicaid