MEDICARE: DR. BARBARA M KUCZYNSKI 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	207W00000X	Ophthalmology Physician	4301063340	MI

General Provider Information

NPI Number	:	1912981234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA M KUCZYNSKI MD

Provider Business Mailing Address
First Line	:	30150 TELEGRAPH RD STE 271
Second Line	:
City	:	BINGHAM FARMS
State	:	MI
Zip	:	48025-4521
Country	:	US
Telephone Number	:	248-395-5175
Fax Number	:	734-743-2138

Provider Business Practice Location Address
First Line	:	330 E 14 MILE RD
Second Line	:	STE B
City	:	CLAWSON
State	:	MI
Zip	:	48017
Country	:	US
Telephone Number	:	248-589-9500
Fax Number	:	248-589-9587

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	02/20/2023

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