MEDICARE: DR. GEORGE ALAN KRZYMOWSKI M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	4301056986	MI

General Provider Information

NPI Number	:	1417905258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ALAN KRZYMOWSKI M.D.

Provider Business Mailing Address
First Line	:	741 LAKEWOOD LN
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-9519
Country	:	US
Telephone Number	:	906-249-1672
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 W BARAGA AVE
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-4550
Country	:	US
Telephone Number	:	906-449-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	06/12/2019

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