Provider Demographics
NPI:1760662746
Name:PATRICK H. MACEDONIA, M.D., INC.
Entity Type:Organization
Organization Name:PATRICK H. MACEDONIA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:H
Authorized Official - Last Name:MACEDONIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-283-7100
Mailing Address - Street 1:1 ROSS PARK BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2681
Mailing Address - Country:US
Mailing Address - Phone:740-283-7100
Mailing Address - Fax:
Practice Address - Street 1:1 ROSS PARK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2681
Practice Address - Country:US
Practice Address - Phone:740-283-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH39108207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0374296Medicaid
OH0374296Medicaid
OH0452912Medicare PIN