Provider Demographics
NPI:1982624433
Name:MASCHEK, MICHAEL AARON (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:AARON
Last Name:MASCHEK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31463
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0167
Mailing Address - Country:US
Mailing Address - Phone:251-200-3703
Mailing Address - Fax:334-493-9535
Practice Address - Street 1:702 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OPP
Practice Address - State:AL
Practice Address - Zip Code:36467-1626
Practice Address - Country:US
Practice Address - Phone:334-493-5704
Practice Address - Fax:334-493-9535
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL351213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1000695OtherQUAL CHOICE
OH107975OtherKAISER PERMANENTE
OH2479170Medicaid
OH7037259OtherCIGNA
OH000000342415OtherANTHEM BC/BS
OH2479170Medicaid
OH000000342415OtherANTHEM BC/BS
OHU98825Medicare UPIN