Healthcare Provider Details

I. General information

NPI: 1356398820
Provider Name (Legal Business Name): JANIS MARIE RYGWELSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E WASHINGTON ST SUITE G
DEWITT MI
48820-8826
US

IV. Provider business mailing address

124 E WASHINGTON ST SUITE G
DEWITT MI
48820-8826
US

V. Phone/Fax

Practice location:
  • Phone: 517-881-7750
  • Fax: 517-668-0755
Mailing address:
  • Phone: 517-881-7750
  • Fax: 517-668-0755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301053706
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: