MEDICARE: ANDRZEJ DMOWSKI MD

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	207P00000X	Emergency Medicine Physician	ME79755	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49780	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518960996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRZEJ DMOWSKI MD

Provider Business Mailing Address
First Line	:	1300 N 12TH ST
Second Line	:	SUITE 301
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2848
Country	:	US
Telephone Number	:	602-239-6968
Fax Number	:	602-239-4144

Provider Business Practice Location Address
First Line	:	1300 N 12TH ST
Second Line	:	SUITE 301
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2848
Country	:	US
Telephone Number	:	602-239-6968
Fax Number	:	602-239-4144

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	04/18/2008

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