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General NPI Number Information
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NPI Number | 1861550774
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Entity Type | Individual
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Provider Name | MICHAEL F JAWORSKI MD
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7141 SECURITY BOULEVARD
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City | BALTIMORE
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State | MD
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Zip | 21244-1811
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Country | US
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Telephone | 443-663-6000
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Fax | 443-663-6172
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Provider Business Mailing Address
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Address Line | KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP 2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W
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City | ROCKVILLE
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State | MD
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Zip | 20852-4908
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Country | US
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Telephone | 301-816-6660
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Fax | 301-816-6380
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D15460
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License Number State | MD
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