Provider Demographics
NPI:1295885044
Name:JACHOWSKI, MAILE APAU (MD)
Entity type:Individual
Prefix:DR
First Name:MAILE
Middle Name:APAU
Last Name:JACHOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAILE
Other - Middle Name:JEAN APAU
Other - Last Name:JACHOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7401 RANGE RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-2420
Mailing Address - Country:US
Mailing Address - Phone:703-768-5861
Mailing Address - Fax:
Practice Address - Street 1:1058 WEST PERIMETER ROAD
Practice Address - Street 2:79 MDOS SGOPP
Practice Address - City:ANDREWS AFB
Practice Address - State:MA
Practice Address - Zip Code:20762
Practice Address - Country:US
Practice Address - Phone:240-857-2723
Practice Address - Fax:240-857-6263
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061122208000000X
HIMD 8775208000000X
VA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIF83127Medicare UPIN