Provider Demographics
NPI:1801476148
Name:MIASKOWSKI, MACIEJ (MD)
Entity type:Individual
Prefix:DR
First Name:MACIEJ
Middle Name:
Last Name:MIASKOWSKI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE # B620
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:608-266-6730
Mailing Address - Fax:608-266-6742
Practice Address - Street 1:9000 W WISCONSIN AVE # B620
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:608-266-6730
Practice Address - Fax:608-266-6742
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI83736-20208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics