Healthcare Provider Details

I. General information

NPI: 1558457390
Provider Name (Legal Business Name): SUSAN ELIZABETH CZAPIEWSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR 116A
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

1 VETERANS DR 116A
MINNEAPOLIS MN
55417-2309
US

V. Phone/Fax

Practice location:
  • Phone: 612-467-3535
  • Fax: 612-725-2292
Mailing address:
  • Phone: 612-467-3535
  • Fax: 612-725-2292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number32850
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: