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NPI 1013467794

NPI 1013467794 : DR. MICHAEL T. OWCZARZAK, P.C. : FLINT, MI

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General NPI Number Information
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    NPI Number           |    1013467794
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    Entity Type          |    Organization 
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    Legal Business Name  |    DR. MICHAEL T. OWCZARZAK, P.C. 
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Dates
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    Enumeration Date     |    10/06/2016
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    Last Update Date     |    10/06/2016
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Provider Practice Location Address
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    Address Line         |    5142 MILLER RD 
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    City                 |    FLINT
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    State                |    MI
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    Zip                  |    48507-1042
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    Country              |    US
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    Telephone            |    810-733-3660
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    Fax                  |    810-720-4777
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Provider Business Mailing Address
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    Address Line         |    5142 MILLER RD 
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    City                 |    FLINT
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    State                |    MI
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    Zip                  |    48507-1042
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    Country              |    US
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    Telephone            |    810-733-3660
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    Fax                  |    810-720-4777
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Authorized Official
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    Title or Position    |    PHYSICIAN
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    Name                 |    DR. MICHAEL T OWCZARZAK 
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    Credential           |    MD
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    Telephone            |    810-733-3660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    4301068046
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    License Number State |    MI
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