MEDICARE: KRZYSZTOF T LEWANDOWSKI MD

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	ME70941	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093105249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRZYSZTOF T LEWANDOWSKI MD

Provider Business Mailing Address
First Line	:	2101 NORTHSIDE DR
Second Line	:	601
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-3687
Country	:	US
Telephone Number	:	850-747-9969
Fax Number	:	850-747-1052

Provider Business Practice Location Address
First Line	:	2101 NORTHSIDE DR
Second Line	:	601
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-3687
Country	:	US
Telephone Number	:	850-747-9969
Fax Number	:	850-747-1052

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	KRZYSZTOF T LEWANDOWSKI
Credential	:	MD
Telephone Number	:	850-747-9969

Provider Enumeration Date	:	01/27/2015
Last Update Date	:	01/27/2015

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