MEDICARE: RICHARD DUSZAK JR. 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	2085R0202X	Diagnostic Radiology Physician	070739	GA

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	:	1124022637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD DUSZAK JR. M.D.

Provider Business Mailing Address
First Line	:	1365 CLIFTON RD NE
Second Line	:	EMORY UNIVERSITY DEPARTMENT OF RADIOLOGY
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	202-688-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE
Second Line	:	EMORY UNIVERSITY DEPARTMENT OF RADIOLOGY
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	202-688-5300
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	12/12/2013

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