Healthcare Provider Details

I. General information

NPI: 1013980937
Provider Name (Legal Business Name): MICHAEL PAUL SZCZEPANSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

IV. Provider business mailing address

6315 NODDING NIGHT CT
COLUMBIA MD
21044-6012
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-2997
  • Fax:
Mailing address:
  • Phone: 253-686-2825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number23209
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number23209
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: