Basic Information
| Provider Information | |||||||||
| NPI: | 1962883983 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | MAJETICH | ||||||||
| FirstName: | SIMONE | ||||||||
| MiddleName: | ADDISON | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7590 AUBURN ROAD, SUITE 014 | ||||||||
| Address2: | ATTN: MED STAFF | ||||||||
| City: | CONCORD TWP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440779176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403541899 | ||||||||
| FaxNumber: | 4403541845 | ||||||||
| Practice Location | |||||||||
| Address1: | 27100 CHARDON RD | ||||||||
| Address2: | MEDICAL EDUCATION, UNIVERISTY HOSPITALS | ||||||||
| City: | RICHMOND HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441431116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405856553 | ||||||||
| FaxNumber: | 4405856141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2015 | ||||||||
| LastUpdateDate: | 03/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 58.006019 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.