Maciolek, Lawrence John

Maciolek, Lawrence John is an individual health care provider with primary practice located at 525 W River Woods Parkway Suite 130, Glendale WI 53212. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Maciolek, Lawrence John can be contacted via phone (414) 961-0304.

Contact Information

Primary practice address
525 W River Woods Parkway Suite 130 Glendale WI 53212
Phone: (414) 961-0304
Fax: (414) 961-2061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 45567-020 Wisconsin
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 45567-20 Wisconsin

Profile Details

NPI number 1811925381
LBN Legal business name Maciolek, Lawrence John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Nov 6th, 2019 - about 5 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 1811925381 NPPES
Wisconsin MEDICAID 34908400

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