Healthcare Provider Details

I. General information

NPI: 1700096062
Provider Name (Legal Business Name): WLODZIMIERZ SZCZARKOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SUMMIT VIEW DR
BRENTWOOD TN
37027-4645
US

IV. Provider business mailing address

5417 COCHRAN DR
NASHVILLE TN
37220-2334
US

V. Phone/Fax

Practice location:
  • Phone: 615-370-8393
  • Fax:
Mailing address:
  • Phone: 615-469-2544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number28531
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: