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General NPI Number Information
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NPI Number | 1790006328
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Entity Type | Organization
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Legal Business Name | JADWIGA MALACZYNSKI, M.D.,PC
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 3120 CARPENTER SUITE 311
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City | HAMTRAMCK
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State | MI
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Zip | 48212-2783
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Country | US
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Telephone | 313-369-3365
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Fax | 313-893-3875
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Provider Business Mailing Address
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Address Line | 3120 CARPENTER SUITE 311
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City | HAMTRAMCK
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State | MI
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Zip | 48212-2783
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Country | US
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Telephone | 313-369-3365
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Fax | 313-893-3875
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JADWIGA KAZIMIERA MALACZYNSKI
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Credential | M.D.
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Telephone | 313-369-3365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 4301061286
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License Number State | MI
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