Provider Demographics
NPI:1952390510
Name:MAJKA, DOUGLAS EUGENE (PT)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:EUGENE
Last Name:MAJKA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8960 ELMWOOD OVAL
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-1334
Mailing Address - Country:US
Mailing Address - Phone:440-582-2847
Mailing Address - Fax:
Practice Address - Street 1:18660 BAGLEY RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3480
Practice Address - Country:US
Practice Address - Phone:440-234-8300
Practice Address - Fax:440-234-8474
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-01835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0593175Medicaid