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General NPI Number Information
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NPI Number | 1639777287
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Entity Type | Individual
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Provider Name | PIOTR Z PURZYCKI PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 468 CADIEUX RD
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City | GROSSE POINTE
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State | MI
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Zip | 48230-1507
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Country | US
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Telephone | 313-473-6899
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Fax |
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Provider Business Mailing Address
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Address Line | 41400 DEQUINDRE RD STE 101
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-3751
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Country | US
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Telephone | 586-843-3815
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601010185
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License Number State | MI
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