Healthcare Provider Details

I. General information

NPI: 1417918632
Provider Name (Legal Business Name): DAVID R. MARKIEWICZ CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SOUTH BLVD E STE 300
ROCHESTER HILLS MI
48307-6120
US

IV. Provider business mailing address

1701 SOUTH BLVD E STE 300
ROCHESTER HILLS MI
48307-6120
US

V. Phone/Fax

Practice location:
  • Phone: 586-493-8747
  • Fax: 586-493-8741
Mailing address:
  • Phone: 586-493-8747
  • Fax: 586-493-8741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704228699
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: