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General NPI Number Information
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NPI Number | 1003259250
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Entity Type | Individual
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Provider Name | KAROLINA MAKSIMOWSKI
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Gender | Female
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN ST
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City | DETROIT
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State | MI
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Zip | 48201-2119
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Country | US
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Telephone | 313-745-5260
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Fax | 313-966-0665
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Provider Business Mailing Address
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Address Line | 4201 ST. ANTOINE UHC 5D MAILBOX 226
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-745-4405
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Fax | 313-966-0665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 56541
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301114213
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35128153
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 4301114213
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License Number State | MI
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