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NPI Code Detail

MEDICARE: DR. JOHN MICHAEL SCZOMAK PHD

MEDICARE:  DR. JOHN MICHAEL SCZOMAK  PHD
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
1103T00000XPsychologist6301002569MI

General Provider Information

NPI Number : 1821088717
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN MICHAEL SCZOMAK PHD
Provider Business Mailing Address
First Line : 23850 BUCKINGHAM ST
Second Line :
City : DEARBORN
State : MI
Zip : 48128-1632
Country : US
Telephone Number : 248-496-6885
Fax Number :
Provider Business Practice Location Address
First Line : 882 OAKMAN BLVD
Second Line : SUITE D
City : DETROIT
State : MI
Zip : 48238-3710
Country : US
Telephone Number : 248-496-6885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 11/15/2013

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Directions to “ DR. JOHN MICHAEL SCZOMAK PHD” Practice Location

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