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General NPI Number Information
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NPI Number | 1700091345
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Entity Type | Organization
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Legal Business Name | PETER ZADVINSKIS MD PC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 705 OAK ST SUITE #5
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City | BIG RAPIDS
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State | MI
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Zip | 49307-3107
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Country | US
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Telephone | 231-592-5507
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Fax | 231-592-4841
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Provider Business Mailing Address
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Address Line | 705 OAK ST SUITE #5
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City | BIG RAPIDS
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State | MI
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Zip | 49307-3107
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Country | US
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Telephone | 231-592-5507
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Fax | 231-592-4841
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Authorized Official
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Title or Position | OWNER
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Name | PETER Z ZADVINSKIS
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Credential | MD
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Telephone | 231-592-5507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PZ056351
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License Number State | MI
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