Healthcare Provider Details

I. General information

NPI: 1922106897
Provider Name (Legal Business Name): ROBERT KRYWICKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 W 3RD AVE
ALBANY GA
31701-1975
US

IV. Provider business mailing address

427 W 3RD AVE
ALBANY GA
31701-1975
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-1000
  • Fax:
Mailing address:
  • Phone: 229-312-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number040445
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: