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General NPI Number Information
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NPI Number | 1023013737
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Entity Type | Individual
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Provider Name | GEORGE JOHN HAIDUKEWYCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 89 W COPELAND DR 3RD FLOOR
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City | ORLANDO
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State | FL
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Zip | 32806-2028
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Country | US
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Telephone | 407-649-6878
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Fax | 407-843-7381
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Provider Business Mailing Address
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Address Line | 89 W COPELAND DR 3RD FLOOR
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City | ORLANDO
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State | FL
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Zip | 32806-2028
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Country | US
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Telephone | 407-649-6878
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Fax | 407-843-7381
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | ME75428
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME75428
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License Number State | FL
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