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General NPI Number Information
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NPI Number | 1497135974
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Entity Type | Individual
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Provider Name | JOEL SZYMANSKI DO
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Gender | Male
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 399 S BROADWAY ST
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City | LAKE ORION
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State | MI
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Zip | 48362-2740
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Country | US
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Telephone | 248-693-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 603 LUDLOW AVE
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City | ROCHESTER
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State | MI
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Zip | 48307-1421
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Country | US
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Telephone | 586-722-8768
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 5101021743
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License Number State | MI
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