Macieski, Dennis C

Macieski, Dennis C is an individual health care provider with primary practice located at 2325 Coronado St , Idaho Falls ID 83404-7407. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Macieski, Dennis C can be contacted via phone (208) 552-2700.

Contact Information

Primary practice address
2325 Coronado St Idaho Falls ID 83404-7407
Phone: (208) 552-2700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X N-18888 Idaho

Profile Details

NPI number 1225065196
LBN Legal business name Macieski, Dennis C
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Jul 12th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225065196 NPPES
Idaho MEDICAID 004378000

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