MEDICARE: JUSTIN K SKRZYNSKI, MD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1184146326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUSTIN K SKRZYNSKI, MD, PLLC

Provider Business Mailing Address
First Line	:	4157 AUBURN DR
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48073-6341
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28747 WOODWARD AVE
Second Line	:
City	:	BERKLEY
State	:	MI
Zip	:	48072-0929
Country	:	US
Telephone Number	:	248-584-4602
Fax Number	:

Authorized Official
Title or Position	:	SOLE PRACTITIONER PHYSICIAN
Name	:	JUSTIN SKRZYNSKI
Credential	:	MD
Telephone Number	:	248-228-4823

Provider Enumeration Date	:	07/10/2017
Last Update Date	:	08/30/2017

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