Provider Demographics
NPI:1336213669
Name:MAJKRZAK, RAYMOND S (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:S
Last Name:MAJKRZAK
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 1:500 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1569
Mailing Address - Country:US
Mailing Address - Phone:906-483-1040
Mailing Address - Fax:906-483-1044
Practice Address - Street 1:500 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1569
Practice Address - Country:US
Practice Address - Phone:906-483-1040
Practice Address - Fax:906-483-1044
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301050147207V00000X
MN50429207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI103311416Medicaid
HP92808OtherHEALTHPARTNERS
0705738OtherMEDICA
MN71S88MAOtherMN BCBS
MN043495000Medicaid
ND30978OtherND BCBS
0705738OtherMEDICA
MI103311416Medicaid
HP92808OtherHEALTHPARTNERS