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General NPI Number Information
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NPI Number | 1336172659
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Entity Type | Individual
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Provider Name | JAN PIJANOWSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 4355 STARKEY RD
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City | ROANOKE
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State | VA
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Zip | 24018-0610
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Country | US
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Telephone | 540-397-2875
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Fax |
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Provider Business Mailing Address
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Address Line | 3232 W RIDGE RD SW
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City | ROANOKE
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State | VA
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Zip | 24014-4221
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Country | US
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Telephone | 540-397-2875
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101223435
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License Number State | VA
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