Provider Demographics
NPI:1811069644
Name:MAJERCIK, DONALD A (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:A
Last Name:MAJERCIK
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 1:18 PEARL STREET
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452
Mailing Address - Country:US
Mailing Address - Phone:802-879-6681
Mailing Address - Fax:802-879-0538
Practice Address - Street 1:18 PEARL STREET
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452
Practice Address - Country:US
Practice Address - Phone:802-879-6681
Practice Address - Fax:802-879-0538
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0005357Medicaid
VTD78595Medicare UPIN
VT0005357Medicaid