Healthcare Provider Details

I. General information

NPI: 1144302720
Provider Name (Legal Business Name): IWONA PODZIELINSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 N DETROIT ST
WARSAW IN
46580-2985
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 260-436-0800
  • Fax: 260-483-1911
Mailing address:
  • Phone: 855-963-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01062592
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number01062592A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: