Provider Demographics
NPI:1023004082
Name:MICHALSKI, JOHN ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ALEXANDER
Last Name:MICHALSKI
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 1:90 N 4TH ST
Mailing Address - Street 2:MICHALSKI ORTHOPEDIC CENTER, LLC
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-1648
Mailing Address - Country:US
Mailing Address - Phone:740-633-4790
Mailing Address - Fax:740-633-4144
Practice Address - Street 1:800 WHEELING AVE FL 1
Practice Address - Street 2:
Practice Address - City:GLEN DALE
Practice Address - State:WV
Practice Address - Zip Code:26038-1660
Practice Address - Country:US
Practice Address - Phone:304-221-4520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.078449207X00000X
OH78449207X00000X
WV20227207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV18032630000Medicaid
OH2194629Medicaid
WV18032630000Medicaid
OH2194629Medicaid