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NPI Code Detail

MEDICARE: THOMAS CARL ZIOLKOWSKI D.O.

MEDICARE: THOMAS CARL ZIOLKOWSKI D.O.
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
1208600000XSurgery Physician5101021507MI

General Provider Information

NPI Number : 1295975068
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS CARL ZIOLKOWSKI D.O.
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 707 S GREENVILLE WEST DR
Second Line :
City : GREENVILLE
State : MI
Zip : 48838-2102
Country : US
Telephone Number : 616-754-3001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2009
Last Update Date : 02/23/2021

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