MEDICARE: DR. ALAN GEORGE CZARKOWSKI D.O.

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	2083X0100X	Occupational Medicine Physician	029317	GA

General Provider Information

NPI Number	:	1154526457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN GEORGE CZARKOWSKI D.O.

Provider Business Mailing Address
First Line	:	PO BOX 1397
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30031-1397
Country	:	US
Telephone Number	:	404-498-4775
Fax Number	:	404-498-4776

Provider Business Practice Location Address
First Line	:	57 EXECUTIVE PARK SOUTH NE
Second Line	:	BLDG 57, SUITE 2301
City	:	ATLANTA
State	:	GA
Zip	:	30329-2288
Country	:	US
Telephone Number	:	404-498-4775
Fax Number	:

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	07/08/2007

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