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General NPI Number Information
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NPI Number | 1144401340
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Entity Type | Organization
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Legal Business Name | MICHAEL A KWIAT MD
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 1360 SHARON RD
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City | BEAVER
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State | PA
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Zip | 15009-3128
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Country | US
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Telephone | 724-773-0216
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Fax | 724-773-0219
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Provider Business Mailing Address
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Address Line | 1360 SHARON RD
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City | BEAVER
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State | PA
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Zip | 15009-3128
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Country | US
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Telephone | 724-773-0216
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Fax | 724-773-0219
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL A KWIAT
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Credential | MD
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Telephone | 724-773-0216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD043875L
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License Number State | PA
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