MEDICARE: DR. MICHAEL JAWORSKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD429299	PA

General Provider Information

NPI Number	:	1013035492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JAWORSKI M.D.

Provider Business Mailing Address
First Line	:	1316 W ONTARIO ST RM 815
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5220
Country	:	US
Telephone Number	:	215-707-3635
Fax Number	:

Provider Business Practice Location Address
First Line	:	1316 W ONTARIO ST RM 815
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5220
Country	:	US
Telephone Number	:	215-707-3635
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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